Program 1



  1. General Counselling I
  2. General Counselling II
  3. General Counselling III
  4. General Counselling IV
  5. General Counselling V
  6. General Counselling VI
  7. General Counselling VII
  8. Modifying Maladaptive Thinking

Identifying Negative Feelings and Thoughts

Challenging Negative Feeling and Thoughts

Distorted Thinking

Thought Management Procedures

Self-Instructional Training

Strengthen Conviction in Alternative Functional Beliefs

  1. Behavioural Principles
  2. Summary for Cognitive Behavioural Change
  3. Planning an Activity Schedule
  4. Forgiveness
  5. Frustration
  6. Competitiveness and Perfectionism
  7. Troublesome Emotions









Healthy and Unhealthy Emotions

  1. Improving Your Self-Image and Combating Self-Harm
  2. Coping with the Need for Approval
  3. Distraction Techniques
  4. Problem-Solving
  5. Procrastination
  6. Managing Your Time
  7. Controlled Breathing and Relaxation Techniques
  8. Sleep Management
  9. Exercise
  10. Nutrition
  11. Meditation
  12. Creative Visualization
  13. Self-Hypnosis
  14. Autogenics
  15. Eye Movement Technique (EMT)
  16. Mood Induction Procedure
  17. Rational Emotive Imagery (REI)
  18. Imago Graded Exposure
  19. In Vivo Graded Exposure
  20. Persistence
  21. Criticism
  22. Countering Self-Criticism
  23. Assertiveness Training
  24.  Building Confidence I
  25. Building Confidence II
  26. Building Confidence III
  27. Building Confidence IV
  28. You and Your Family
  29. Removing the Obstacles to Intimacy
  30. Sexual Problems
  31. Dealing with Relationships
  32. Neuro-Linguistic Programming (NLP)
  33. Communication Training
  34. Negotiation Training
  35. Timetabled Activities
  36. Reversed Role Play
  37. Time–Limited Trivial Arguments
  38. Triangles
  39. Social Skills Training
  40. Making Your Love Last
  41. Medication
  42. Relapse Prevention

       1. General Counselling I

Write down your story so that you are clear about what it is that concerns you. What is the worst case scenario and how could you cope? Look at the past and consider the problems you experienced and how you coped. What did you envisage for yourself in the past? Clarify the present to yourself and what you want for the future. What is your ideal scenario and how can you achieve it – what changes will you need to make? Set realistic goals and work toward them in small manageable steps.

What concerns you? What are the negative things about your current life? Write these down then consider the more positive things in your life.

Evaluate your commitment to change. It may take a few weeks to a few months to see any changes and you will need to persevere and keep up the effort despite occasional setbacks.

Deepen your understanding of both yourself and the situation you are seeking a solution to, by summarizing what you have considered so far – this will enable you to begin to see yourself and the situation in a new light.

Think about what you would like to get out of this advice, for example, improve: living skills, physical lifestyle, interpersonal relationships (especially get more support from your partner and make sure they understand your difficulties), and overcome your problem.

Note the negative elements that push you and your partner apart (e.g. jealousy). What are the positive elements that draw you and your partner together (e.g. affection and good memories of the relationship)?

Consider any manoeuvres (brief, limited interpersonal operation; unhealthy objective; predictable, repetitive; unconscious; you have superficial rationalizations to explain behaviour) or stratagems (like a manoeuvre but is a prolonged interpersonal operation) you may be using (e.g. you or your partner may deliberately start an argument every time the other wants to talk about their problems).  

Determine whether you or your partner is using the Illness stratagem and linking complications of anxiety to the other’s alleged non-compliance. Perhaps your partner feels a corrupted sense of obligation to you.

You need to understand that a well-functioning family faces problems by: openly communicating; exploring options; seeking outside help if they need it.

Explore a game playing family’s coping mechanisms:

Denial – are you and your partner denying anything is wrong or that something was wrong but will not happen again?

Projection – are you accusing each other of your own inadequacies or blaming each other for the behaviours that cause your inadequacies?

Sabotage – is your partner unconsciously trying to sabotage your recovery?

Triangling – are you forcing your child to take sides? Do you understand the detrimental effects on your child?

Keeping Secrets – does your family have secrets which keep outsiders away and bond the family together?

Peace comes with release from parental control so consider the level of enmeshment you have with your parents. Are you continually giving in to your parents or do you do just the opposite of giving in to your parents? You are still enmeshed with your parents if you have: 4 or more self-defeating beliefs (beliefs that place responsibility on your shoulders for how your parents feel); more than 10 feelings that are connected to beliefs that are of guilt, anger, fear or sadness; 2 or more compliant or aggressive behaviours rooted by game playing parents.

Beliefs lead to rules. All feelings make a person obey these rules and that is what leads to behaviour in any transaction. It is necessary to connect feelings to beliefs to understand your behaviour. If you find it difficult to express your feelings you may suffer from physical symptoms which may need medical help if they persist.

Explore any painful events of childhood and reject responsibility for them and assign responsibility to your parents (specific others). Use the ‘Empty Chair’ technique to talk to the person responsible, in a child ego state. Imagine the person responsible is in an empty chair placed before you and talk to them, as the child within you.

If you suffered sexual abuse as a child you will have negative patterns of victimization feelings (e.g. ‘I never had a childhood’). You need to work through your outrage, grief and release.

Deal with the issue with role play and by writing letters to:

The aggressor/s.

The other parent or both parents.

The damaged child from the adult self.

A fairy tale in the third person about your life with a happy ending.

To your partner or ex-lover.

To your child/children or the child you would like to have.

You need not send these letters. Repeat the series of letters as you progress with this advice to see the changes with therapy.

Visualize the first time you remember being molested (or a recent incident where you submitted to someone you feared), and see yourself push your aggressor away, saying:


‘I won’t!’

‘Go away!’ etc.

Imagine the abuser exiting the room, becoming increasingly smaller as they leave the room.

Repeat the phrases until they are convincing. With practise your sense of helplessness is likely to diminish.

You may wish to confront your abuser. Decide whether to do so face to face, by phone or in writing. It is necessary that you cover:

What they did to you.

How you felt about it at the time.

How it affected your life.

What you want from them now.

If your abuser has passed on, you can still confront them in writing and read it aloud at their grave.

See Program 10: Overcoming Childhood Abuse.

Chemistry influences how you think and how you think influences your body chemistry. Thoughts are drugs and drugs are thoughts. Ideas are drugs.

Perhaps you should make regular times for recreational activity with your partner and try to communicate with your partner after you have both enjoyed such activity and are in a good mood.

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                 2. General Counselling II

You need to:

Set specific goals, for example, to spend constructive time with your partner and child/children; avoid making your child take sides in your arguments with your partner; improve your physical lifestyle; take steps to socialize more.

Establish reward systems for all successes no matter how small.

Keep records of your changes perhaps in a diary.

Try to act in accordance with the way you would like to be.

Freely express your feelings so that if you have been ‘wearing a mask’ and ‘people pleasing’ you will assert your right to expression of feelings and find you are capable of such expression.

You need to have love and compassion for yourself or you will never have sufficient to give away. It is necessary to have the courage to experiment and take risks. In this way you will find freedom from yourself and your habitual, enslaving misconceptions. Accept your place in the world with your limitations and beware of worshipping anyone else. Remember that there is always the opportunity for growth and that you should never think you have the final answer.

For permanent change it is essential that you deal with your perceptions of how you see reality, and alter these perceptions. What you do influences who you are and how you feel about yourself.

Replace unwanted habits with desired habits (e.g. you may stay up late – you should try to change this and sleep earlier so you feel sufficiently refreshed during the day). Consider your negative thoughts and try to replace these with more positive thoughts. You need to experience intense feelings, confront fears, and still maintain control of your life. Focus on your strengths – be aware that everyone has weaknesses.

Eliminating one problem will lead to new problems from an expanding lifestyle. Explore the negative and positive consequences of change (e.g. socializing more may please your partner and your interpersonal relationships will improve but entertaining or going out can be expensive).

Explore if you and your partner are not achieving your desired closeness due to: a need to disguise your real thoughts and feelings; hiding behind your public mask; making it hard for each other to be open by becoming angry when one partner opens up; avoiding openness by verbal hints and hurts or withdrawing into a shell.

Consider whether in choosing a partner you have attempted to fulfill some ‘magical’ expectation or satisfy unresolved infantile needs (e.g. seeking a father/mother figure). Do you compulsively repeat conflict situations in the unconscious endeavour to master them?

Work on developing your communication skills:

Non-defensive Communication.

Refusing to argue can be empowering. Try using non-defensive responses. For example:

‘I’m sorry you’re upset’

‘I’m taking responsibility for my actions’

‘That’s interesting’

‘Let me think about that’

‘Let’s talk when you’re feeling calmer’

‘You’re entitled to your own opinion’

‘We’ll never get anywhere if you keep yelling at me’

‘That’s your choice, but I’ve made my decision’

Also, use a non-threatening/non-offensive communication style, so the other person does not feel defensive:

Use ‘I’ statements [so the focus is on you].

Do not try to change a person [that is their responsibility and beyond your power].

Avoid arguing in circles [‘chick and egg’ discussion].

Position statements define where you stand on a matter, and what is or is not negotiable [such as ‘I am willing to…’ and ‘I am not willing to…’].

See Communication Training.

Set short-term goals and attain them. Have an active approach to this advice and practise your new behaviours until they replace the old.

What behaviours do you want increased/maintained? Be aware that:

Positive reinforcement is when a partner does something and the consequence is pleasant or desired.

Aversion escape is when a partner does something and as a consequence something bad ceases.

Aversion avoidance is when one partner fears something will occur and as a result of what they do, it does not happen.

The latter two keep negative things from occurring against one of seeking mutual pleasure. Focus on behaviours causing mutual pleasure.

In establishing ‘replacement behaviours’ you and your partner need to be aware of:

The things your partner does that bring pleasure.

The behaviours that do not bring pleasure.

The behaviours that you would like to see changed in your partner.

Focus on what is liked rather than what is not liked. Concentrate on behaviours you want increased/maintained rather than those you want decreased. Consciously practise feeling states (e.g. ‘I feel happy when…’).

Many people never feel fulfilled. They live in the safety of established patterns and not only lack the motivation to change but also the courage to change. To do something despite your fears is to be courageous.

Explore whether you have any ‘security operations’ – ways developed of coping with living in a situation you have evaluated at some point. Consider whether you are selectively inattentive. ‘Selective inattention’ is a deliberate blindness to new evidence threatening, original perceptions (way of seeing) and subsequent adjustments. Be aware that you can become exhausted defending your emotional prison.

When you end a relationship, situation or behaviour, the vacuum created has to be filled with new positive experiences or you will return to the old. If you or your partner feels the need to end the relationship, you will go through the three stage process of grief over loss of a loved one or loss of any form:


A period of suffering or disorganization.

A stage in which you reorganize your life without the loved one.

You should list the old activities and aspects of your life that will support the transition into the new.

See Program 15: Overcoming Grief And Bereavement.

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                  3. General Counselling III

The ‘cause’ of psychological disorders is an interaction of composite factors – genetic, developmental, environmental and psychological.

Determine whether you are neurotic (an inability to interact effectively in a social setting/emotionally reactive), so are suffering from an excess of inhibition/decreased activity; or do excitatory forces dominate so that you are action orientated and emotionally free? If you suffer from an excess of inhibition, gradually increase how active you are as this change in behaviour will change the biology of the brain and influence your entire psychology and personality.

For a sense of relief you need to express in effective action the feelings you experience and which arise from emotions which began as predispositions or tendencies. Emotional freedom is not allowing yourself to be controlled by something outside you.

Consider how you can change from the comfortable and usual to the fulfillment of the exceptional. You need to:

Live in the ‘now’.

Be responsible for you.

Selfishly satisfy your needs.

Give yourself credit for effort as well as success.

Have self-respect and know that failure cannot destroy one.

Be aware that you are out of touch with your feelings if you try to rationalize as to how you DO feel, for example, ‘Well I think…’ OR ‘I think I feel…’ Gut level feelings is being really in touch with your feelings. You are who you believe you are. Individuals with a positive attitude to life, who believe in themselves, lead vibrant fulfilling lives. They use their abilities to the fullest; are comfortable with all human emotions; and travel in confidence.

You need to take the five steps to positive thinking:

To accept you.

To be as you.

To forget you (not be self-centered).

To believe in you.

To belong to you (enjoy a sense of community).

You should not think you are better than anyone else. Accept your weaknesses as part of your whole person to access your full potential. Once you reach a positive, real and honest decision that nothing will defeat you – nothing can.

Determine whether you are suffering from ‘Yes but’ syndrome, where you say ‘Yes but I can’t because…’ to every suggestion no matter how good. Try writing ‘I can’t’ on a large sheet of paper then change this to ‘I can’. Alternatively, change: [I can’t] to [I haven’t yet] to clarify that you have a choice.

Use suggestion therapy – the suggestion must be realistic to your rational mind. Repeat to you daily: ‘Day by day in every way, I am getting better and better’.

Be objective: Where have you been? Where would you like to finish up? You need spiritual fulfillment – a deep contact with other human beings. Consider how this might be achieved; freely explore and analyze areas of your life that are now denied to awareness or distorted.

Determine whether your self-concept (perceived self) is weak/negative or strong/positive. The self develops from continuing evaluations of the child’s behaviour by parents and others. The more you have to deny and take on the values of others, the more uncomfortable you will feel about yourself.

People are different in fundamental ways and it is our mission impossible to make all those near us, just like us. You need to know that you can deal effectively with your life problems if you make full use of your awareness of what is happening in and around you. Try to accept your inner feelings and not fear them.

As you proceed with this advice you will become more vitally and fully involved in all phases of life and your communication with self and others will be more freely expressed. Your faith and hope in your ability to change and your faith and hope that this advice can help you to change, provide the energy for the development of curative forces in the process of therapy.

From existing for the expectancies of others you will move to being a person in your own right. Consider the room you feel to express the variety of feelings you can experience in general – this is indicative of the freedom you experience.

You may feel that nothing can be done to change the situation. Try to think about the more positive aspects of your life to encourage you to change. To be positive is to rely on what is immediately available to the consciousness as away to the truth.

Explore your identity. Have you committed yourself to a life goal; conformed to your parents’ values; adopted a deviant identity; not got a strong sense of identity? Keep in mind that personal identity is not static – it may change in later life even.

Consider whether you feel frustrated and be aware that frustration can occur from obstacles to a desired goal. Your physical and social environment and own limitations present obstacles.

See Frustration.

Do you suffer from ambivalence? A goal which is wanted and not wanted at once produces an ambivalent attitude.

Be clear that approach-avoidance conflict occurs between the following motives:

Independence versus dependence – in times of stress we may become dependent but are taught that independence shows maturity.

Intimacy versus isolation – we may desire to be close to someone but fear rejection.

Co-operation versus competition – there is much emphasis on competitiveness but we are urged to co-operate with others.

Impulse expression versus moral standards – our innate impulses such as sex and aggression are regulated by society but may be in conflict with moral standards.

Do you suffer such conflict? You need to reach a compromise, otherwise aggression, apathy, regression and anxiety may result.

Anxiety is produced by any situation that threatens the well-being of the individual. You may deal with stressful situations by using a combination of defensive (defending against anxiety rather than dealing with the problem) and coping (dealing directly with the stressful situations) strategies.

See Program 8: Overcoming Anxiety.

Explore defensive strategies:

Denial – an unpleasant external reality may be denied to exist.

Repression – threatening impulses or memories may be excluded from action or conscious awareness.

Rationalization – assigning logical or socially desirable motives to our behaviour so that we ‘seem’ to have acted rationally or properly.

Reaction formation – concealing a motive for behaviour from oneself by giving strong expression to its opposite.

Projection – protecting ourselves from recognizing our own undesirable qualities by assigning them to others in exaggerated amounts or blaming others for causing the behaviours that result in our inadequacies.

Displacement – a motive that cannot be gratified in one form is directed into a new channel.

Be aware that some stress is necessary to normal functioning.

Abnormality is defined by:

Deviation from statistics – statistically infrequent.

Deviation from social norms.

Maladaptive behaviour – behaviour has adverse effects on individual or society.

Personal distress.

Normality is defined by:

How adjusted an individual is to the world.

Efficient perceptions of reality.

Self-knowledge – how aware an individual is of their own motives and feelings.

Ability to exercise voluntary control over behaviour.

Self-esteem and a feeling of acceptance by others.

Ability to form affectionate relationships.


You will get positive reinforcement from this advice, from others and from worthwhile results produced.

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                  4. General Counselling IV

Explore self-regulation to change maladaptive behaviour. Monitor your own behaviour using techniques of:

Self-reinforcement – rewarding you for achieving a specific goal.

Self-punishment – arranging some aversive consequence for failing to achieve a goal.

Controlling stimulus conditions – controlling/avoiding, situations/stimuli that elicit the maladaptive behaviour. Stimulus control is a strategy to control or limit exposure to a trigger or cue.

Developing incompatible responses – record stimuli that elicit maladaptive behaviour, and for each list antagonistic responses.

The more you try to change, the worse the situation will become – instead you should become aware of what you want to change and change will take place by itself.

Explore awareness:

There are three awareness zones: Awareness of – outside world; inside world; fantasy activity. When you focus on one your awareness of the others decreases.

Focusing ability – your awareness acts as a searchlight. What you focus on becomes clear while other things fade.

Generalization – this is fantasy activity of the mind, for example, ‘Now I see the whole room’. Awareness is sharper.

Selection – you selectively focus on things relevant to you.

Avoidance – focusing on certain types of experience is a way of excluding others.

Interruption in flow of awareness is often to avoid something unpleasant.

Withdrawing into inside or fantasy awareness can give rest, support and reveal unfinished situations.

Consider how you can have in-depth communication with others. Keep in mind that when you are honest with yourself and get in touch with your experiencing and express it as your experiencing, others will respond with trust and respect. It is necessary to be aware of your own experience; make the other person aware of your experience; be aware of the other person’s expression of their awareness.

Try to have a silent time with your partner where you have a meal with your partner in silence using words only for emergencies. You will be able to take in and receive experiences that are otherwise drowned by words.

Be aware of the three different types of listening:

Pretend listening – listener only hears key words or phrases and may interrupt the speaker. It is disrespectful.

Passive listening – listener tries to listen without becoming emotionally involved.

Interactive listening – two way communication, making an effort to understand.

Effective speaking consists of:

Being direct – taking responsibility for what we have to say to our partner and being personally available to hear their response.

Being specific – making clear statements and avoiding ambiguity.

Being brief – concise communication is more memorable.

Sending consistent messages – our voice, facial expression and body posture should reflect the same message we are verbalizing.

Using ‘I’ statements – these show the speaker is taking responsibility for the feelings and thoughts they express and not just dumping them on their partner (e.g. ‘I am feeling hurt’ rather than ‘I feel YOU are angry’).

Paraphrasing – this is when we repeat back succinctly in our own words what has been said, to ensure we have understood.

Summarizing – this is a brief statement highlighting the main points of a longer discussion.

As an exercise imagine you have just met your partner and spend time becoming acquainted. After about ten minutes you should explore:

What you were aware of as you became acquainted.

How you got to know each other and to what extent you really met and honestly contacted each other.

How much did you reveal about yourself and your feelings and how much did you keep hidden?

Who took the most active part in this getting acquainted?

Spend time with your partner taking turns stating your appreciation of each other for five minutes then take some time to share the experience of doing this. How did you feel as you gave and received appreciation and what did you become aware of as you did this?

You and your partner need to spend time taking turns repeatedly requesting the other for something they do not want to give you and the partner indirectly says ‘No’. After five minutes share your experience – what did you learn about the way you indirectly say ‘No’?

Try spending time reversing roles with your partner and expressing feelings about the relationship and what is wrong with it.

Good thoughts result in beautiful creations/elementals and bad thoughts in revolting forms/elementals which are dependent on the thoughts to exist. Confront your negative feelings to deny them further power and in this way move on. You never lose anything worth having through release. You need to emotionally release (or gain release from) any person, situation or condition of strong attachment.

Consider forgiveness. It is necessary to know that forgiveness is absolving the guilty party of responsibility; giving up the need for revenge. Forgiveness can go outward or inward. Resentment binds you to a person – forgiveness sets you free.

See Forgiveness.

Writing can be a cathartic process. Try writing about, your:

Sexual history.

Relationship history.

History with your parents.

History of jobs.

Financial history.

Feelings about yourself and the events in your life, both good and bad.

You may wish to share these accounts with a friend, but not your partner until later when you are more comfortable to do so.

Keep a journal of your depression, anger, anxiety, guilt, resentment etc. For example, with a Depression Journal you would make an entry every time you feel depressed. Such a journal can clarify your thoughts, feelings and behaviour when distressed thus, enabling you to make any required changes.

Some general concepts are:

Self-esteem - is our overall self-appraisal of our own worth (low self-esteem equates to low self-confidence and lack of self-respect).

Self-confidence - is faith in one’s own abilities.

Self-image - is what you believe people think about you.

Body image - how a person perceives their own physical appearance.

Body Dysmorphic Disorder (BDD) - is a mental disorder that involves a disturbed body image and is linked to low self-esteem and social anxiety and can be co-morbid (occur in combination) with depression.

Self-awareness - is the understanding that one exists.

Self-consciousness - is understanding one’s core identity.  

Self-acceptance - is accepting yourself as a fallible human being and that while you prefer life to be good to you, it can be a mixture of good, bad and neutral.

Human personality can be described using the ‘Big Five’ factors: (OCEAN) – Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism.

The Johari Window:

Our inner world can be explained by dividing personal awareness into four areas:

Open – known to yourself and others.

Blind – known by others but not yourself.

Secret – known to yourself but not others.

Undiscovered – unknown to yourself and others.

For emotional well-being you need to increase your open area and decrease the other areas by developing your self-awareness and becoming more self-accepting. Seek feedback and challenge your blind spots. Disclose more about yourself as appropriate. Keep a diary to reflect on experience and aid self-discovery.

Abraham Maslow’s ‘Hierarchy of Needs’ is represented by a pyramid with the more primitive needs at the bottom. The higher needs in the hierarchy only come into focus when the lower needs are satisfied. Starting at the base of the pyramid and going up are the following needs:

Physiological needs – breathing, food, water, sex, sleep, homeostasis, excretion.

Safety – security of body, of employment, of resources, of morality, of the family, of health, of property.

Love/Belonging – friendship, family, sexual intimacy.

Esteem – self-esteem, confidence, achievement, respect of others, and respect by others.

Self-actualization (the instinctual need of humans to make the most of their abilities and strive to be the best they can) – morality, creativity, spontaneity, problem-solving, lack of prejudice, acceptance of fact.

Freudian Concepts:

In psychoanalysis unconscious thoughts and feelings are brought to consciousness by encouraging the client to talk in ‘free association’ (the client is invited to relate whatever comes into their mind during the therapy session) and to talk about dreams. Freud argued that the basis of all dream content is wish fulfillment.

‘Transference’ is when the client displaces feelings for someone in their past onto the therapist. ‘Counter transference’ is the therapist’s emotional entanglement with the client. ‘Resistance’ occurs when the client directly or indirectly opposes changing their behaviour and does not fully engage in therapy.[These are psychoanalytic and counselling concepts].

‘Freudian slip’ is an error in speech, memory or physical action that is believed to be caused by the subconscious mind.

Psyche refers to the forces in an individual that influence thought, behaviour and personality.

Id – is the inner desire or impulses.

Superego – is the conscience/social and moral restraints.

Ego – is the mediator between the Id and Superego, and the external world; it acts by taking into account both impulses and morality.

The conscious mind is that of which a person is aware.

The preconscious mind/subconscious mind is all memories that are not conscious but can be easily accessed by the conscious mind.

The unconscious mind is all memories that are hidden from awareness.

The Pleasure Principle – one is continuously driven to seek pleasure and to avoid pain.

The Reality Principle – gratification is deferred when necessary.

Life Drive (Eros) is concerned with survival, propagation, hunger, thirst and sex.

Death Drive (Thanatos) is the drive to return to a state of calm.

Pleasure increases as stimuli decrease. Hence, the ultimate experience of pleasure is zero stimulus of death.

Freud’s Stages of Psychosexual Development:

Oral: 0-18 months (pleasure when nursed).

Anal: 18-36 months (pleasure when defecating).

Phallic: 3-6 years (fixation on mother as a sexual object – Oedipus Complex [Freud] or fixation on father – Electra Complex [Jung]).

Latency: 6 years to puberty (dormant sexual feelings).

Genital: puberty and beyond (sexual interests mature).

Consequences of fixation at any of the above five stages can lead to abnormal behaviour specific to each stage.

Jungian Concepts:

Collective unconscious is all inherited experiences.

Personal unconscious is all material that was once conscious but has been forgotten or suppressed.

Jungian Archetypes:

The Self – the whole person; unified conscious and unconscious.

The Shadow – the aspects of oneself that one does not acknowledge.

The Anima – the feminine image in a man’s psyche.

The Animus – the masculine image in a woman’s psyche.

The Persona – social role or character of a person.

A group of memories and interpretations linked to an archetype is a ‘Complex’.

Erickson’s Stages of Psychosocial Development:

Infancy (Birth -18 months) Psychosocial Crisis: Trust versus Mistrust.

Toddler (1 ½ to 3 years) Psychosocial Crisis: Autonomy versus Shame and Doubt.

Play Age (3-6 years) Psychosocial Crisis: Initiative versus Guilt.

School Age (7-12 years) Psychosocial Crisis: Industry versus Inferiority.

Adolescence (12-18 years) Psychosocial Crisis: Identity versus Role Confusion.

Young Adulthood (19-40 years) Psychosocial Crisis: Intimacy versus Isolation.

Middle Adulthood (40-65 years) Psychosocial Crisis: Generativity (establishing and guiding the next generation) versus Stagnation.

Late Adulthood (from 65 years) Psychosocial Crisis: Integrity versus Despair (what kind of life have I lived?)

You may encounter difficulty in giving up old habits for new ones. Before you allow yourself to be distracted from practising your new habits, weigh the pros and cons and make a responsible decision for when and where you will next consolidate your new habits. Confront your excuses. Proceed in small steps, gradually implementing changes and building on each little success. It could take some time for your new habits to become second nature but at that point you will have made the final step forward in overcoming your problems.

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  5. General Counselling V

Transactional Analysis (Eric Berne):

When two or more people are together one will eventually speak (transactional stimulus) and another person will do something related to the stimulus (transactional response).

There are three structural arrangements within us: Parent [exteropsyche], Adult [neopsyche] and Child [archaeopsyche] (P-A-C). The Parent is the recording of external events; what you have been taught from birth to five years of age. The Adult is the recording of empirical data; what you think from ten months onwards. The Child is the recording of internal events; what you felt from birth to five years of age.

In the Parent ego-state you produce material copied from parental figures; in the Adult ego-state you respond as your present grown-up; in the Child ego-state you replay your own childhood.

Transactions are simple (complementary, crossed) or ulterior (angular, duplex). Transactions can continue ad infinitum when they are complementary transactions:

[A => A A<= A]     [P => P P<= P]     [C => C C<= C] etc.

Uncomplementary/crossed transactions are problematic:

[A => A C <=P] etc.

Angular transactions involve three ego-states.

Duplex transactions involve four ego-states. These transactions have two stimuli and the transaction depends on to which stimulus is the response.

A person with a constant and separated P-A-C reacts to events in a fixed and predictable way with stable mood. In Manic Depression ‘highs’ are when the Child is in charge; ‘lows’ are when the Parent rules; and stable behaviour occurs when the Adult is in control.

When the P-A-C arrangement in a person is NOT separated there are five results:

The Adult is contaminated by the Parent [prejudice].

The Adult is contaminated by the Child [delusion].

The Adult is contaminated by the Parent and excludes the Child [inability to play].

The Adult is contaminated by the Child and excludes the Parent [lack of conscience/psychopathic].

The Adult is excluded with only the Parent and Child present [psychosis].

There are four life positions [Thomas A. Harris]:

I’m Not O.K – You’re O.K. [This is the position of early childhood – the child needs constant affection/stroking].

I’m Not O.K. – You’re Not O.K. [This is the position of the neglected child – the result of inadequate affection/stroking].

I’m O.K.- You’re Not O.K. [This is the position of the battered child – homicidal programming].

I’m O.K. – You’re O.K. [This is the position to strive for via deliberate implementation of A-A transactions].

For effective relationships you need to be free to choose A-A transactions at will when interacting with others. A theoretically ideal relationship has every possible complementary transaction (a total of nine in both directions) for the P-A-C of the couple – additionally the Adult of each individual is emancipated.

A ‘racket feeling’ is experienced repetitively and was learned in childhood to cover another emotion, one that was prohibited in the family of origin. Games are strategies you learned in childhood to manipulate others to meet your needs. Racket feelings are the payoff for a game. You need to stop the game in future by feeling authentic emotions rather than the racket feelings. In this way you will accept adult responsibility for whatever outcome you now choose. Intimacy is part of game free living.

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   6. General Counselling VI

Gestalt Counselling (Fritz Perls):

Gestalt counselling explores the nature of human lives, increasing awareness and is a holistic approach (the whole is more than its constituent parts). Gestalt counselling focuses on the ‘here and now’ experience of the person. What we focus on is called ‘figure’ and the background of our figural experiences is referred to as ‘ground’ (e.g. when reading, the words on the page are the ‘figure’ and the noise of the television in the background is the ‘ground’).  

A person tends to self-regulate normal functions (homeostasis) such as breathing, eating, sexual activity and elimination.

Awareness cycle: an emerging need (Gestalt) becomes a clear ‘figure’, is dealt with to satisfaction and completion, then fades into the background again leading to another meaningful need arising to attention.

When an imbalance in self-regulation occurs the healthy person deals with the dominant need appropriately to restore balance and let the next important need to emerge.

Incomplete experiences lead to psychological tension. When these unfinished experiences become chronic, disability may ensue. Fritz Perls made an analogy between obstructing teething in the infant and harmful behaviour exhibited by the infant in later life.

The healthy Awareness Cycle contains:

Sensation (Resting phase is disrupted by internal or external disturbances) [Dysfunction => Desensitization/minimizing sensation].

Awareness (Being aware of emerging needs)[Dysfunction => Deflection/avoiding stimuli from self or environment].

Mobilization (State of arousal) [Dysfunction => Introjection/being ruled by what you ‘should’ do].

Action (Choosing appropriate action) [Dysfunction => Projection/attributing to others what you do not accept in yourself].

Final contact (Closure of a particular Gestalt/need) [Dysfunction => Retroflection/doing to yourself what you want to do to others or what you want from others].

Satisfaction (Completion of Gestalt/need) [Dysfunction => Egotism/blocking satisfaction].

Withdrawal (Resting phase/homeostasis) [Dysfunction => Confluence/dysfunctional closeness].

Freud described the personality as an iceberg (only a tenth visible). Perls compared the personality to a rubber ball floating in water. Gestalt counsellors deal with the uppermost part of the ball that can be seen.

It is your right to have personal preferences and it can be liberating to contemplate your preferences.

The Gestalt Mantra:

I do my thing, and you do your thing.

I am not in this world to live up to your expectations,

And you are not in this world to live up to mine.

You are you, and I am I.

If by chance we find each other, it’s beautiful.

If not, it can’t be helped.

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   7.  General Counselling VII

Primal Therapy (Arthur Janov):

The neurotic can be described as being an ‘unfeeling person’. To eliminate neurosis it is necessary to unmask the covered feelings of the neurotic patient. Early needs remain unresolved in the neurotic client. These needs are so painful they are suppressed. The person has to feel the pain of the real need and so finally resolve it, becoming a real person, or well. To become real the neurotic must feel the reality of their unreality. Splitting occurs to shut off excessive pain by separating from one’s true needs and feelings, to lead a dual existence. To become whole again, this split has to be felt and recognized. Janov called the feeling of that Primal Pain a Primal. A Major Primal Scene is when splitting takes place. Minor Primal Scenes can build to a Major Primal scene.  

A neurotic’s personality is the way they protect themselves. This defensive personality is removed when their Primal Pains are removed leading to well-being. Neurosis is marked by unnatural tension which drives a person toward resolution. It is necessary for the neurotic to drain the abnormal tension in them, to eradicate their neurotic symptoms and attain a healthy system. The Primal Pool of Pain needs to be drained.

Voluntary and involuntary defenses are behaviours that block real feelings. Voluntary defenses include smoking, drinking, drug use, and overeating. Examples of involuntary defenses are fantasizing, bed wetting, and tightening of the muscles. In neurotics tension tends to be focused in the abdominal area.

When a child’s basic needs (e.g. for affection) are not met, these needs will prevent the child from feeling the present. The neurotic has split off from their childhood and childhood feelings. Their feelings are blocked and manifested as tension. They have to connect with these suppressed feelings. By connecting with their feelings the Primal Pains (sensations of pain) are changed into true feelings and the patient can start living in the present.

The neuroticism of the child who had unloving parents can only be overcome by their feeling again the pain they felt due to the lack of affection in their early years.

‘Feeling is the antithesis of pain’ [Janov]

‘The more pain one feels, the less pain one suffers’ [Janov]

It is the accumulation of hurts that makes a neurosis. Primal therapy is the opposite process to neurosis. The patient will have to feel many Primals before their defense system is broken and they become real (well).

You need to feel the past so you can be free to have a present. Anger, jealousy, fear are all caused by feeling a lack of parental love in early years. The absence of parental affection behind these emotions must be felt in order for these feelings to disappear. The neurotic has to realize the reality of their aloneness to become real (well).

Person-Centered Counselling (Carl Rogers):

The core conditions – the counsellor is required to create a therapeutic relationship with the three conditions of growth.

The therapist needs to:

Be genuine/congruent – the counsellor’s outward response to the client needs to be in harmony with their inner experience of the client.

Offer unconditional positive regard – the counsellor needs to accept, respect and value the client.

Be empathic – the counsellor needs to be able to see the client’s experiencing as if it were their own.

Existential Counselling:

Existential counselling aims to clarify a person’s view on life by exploration of the client’s world view. The client’s experience of the four dimensions of the world (Physical, Social, Personal and Spiritual) is explored. Clients are helped to clarify their assumptions, establish their values, define their talents and learn to live with their emotions.

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                  8. Modifying Maladaptive Thinking

Identifying Negative Feelings and Thoughts

Our thoughts, feelings (emotions), behaviour, physical reactions (physiology) and environment are all inter-connected. Thoughts influence our emotions, behaviour and physical reactions in a given situation. We interpret things that happen to us by many thoughts about what the event conveys to us.  

These thoughts can be automatic and just enter your mind immediately with little or no effort. You may spiral down into more intensely depressed/anxious/angry feelings because one automatic thought can lead to another. Our inner feelings, fantasies, what we notice about our body and past actions can contribute to negative thoughts as well as particular situations.

We can clarify our thoughts by asking ourselves questions. Try not to dwell on these negative thoughts or you may spiral down into more deep intense maladaptive feelings. Train yourself to identify the themes you tend to dwell on and become more aware of your automatic thoughts. Make a habit of writing down your thoughts – this will enable you to become aware of your thinking.

Beliefs are the rules we live by. Values are ‘why we do what we do’ – they are what are important to us (e.g. health, wealth, happiness and love). Basic negative beliefs could be guiding your life and causing negative automatic thoughts. Until you gain knowledge of your automatic thoughts, you may be unaware of these basic beliefs.  

Think about your thoughts and write them down in a notebook. Use four columns to separate:

Triggering Events.

Beliefs and Key Thoughts.


Challenging Your Thoughts.

Start by writing down anything that comes into your mind then learn to grasp your thoughts as your mood changes. Clarify your thoughts by asking questions about how you see yourself as a person, how you think others see you and about implications, including for the future. When you become familiar with grasping and writing down your thoughts, work on the fourth column Challenging Your Thoughts. Continuing reading will help you do this. Beware of negative thoughts such as ‘This is a waste of time – it won’t work for me’. Say to you ‘Even if it does not help, what will I lose from trying?’

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       Challenging Negative Feelings and Thoughts

It is evaluations that are extreme and unrealistic exaggerations which result in distress. To fight negative feelings and thoughts you need to be rational and compassionate. Often we do not see that there is evidence for and against a belief. Decentring is the process of having the patient challenge the basic belief that they are the centre of all events. One way to do this is for the patient to adopt the perspective of another person. Produce alternatives by considering a problem from a number of different viewpoints.

Try to recognize the key advantages and disadvantages of a situation. You can attempt to challenge a block that may be noted. You could do experiments to obtain more evidence for and against your thoughts and beliefs; test things out and practise new skills. Design your experiment step by step to give yourself a chance of success.

Write down and look carefully at your negative thoughts about a specific set of circumstances. Consider how you think when you are well and what you might say to a friend in your position. Challenge and question the validity of your negative thoughts using a rational and compassionate approach. In order to start to challenge your negative thoughts examine the evidence for and against your idea or belief, and try producing alternatives to your negative thoughts and beliefs. Focus on a particular problem and think about the advantages and disadvantages of altering your circumstances.

The manner in which you think about things can cause your problems to increase rather than decrease. When we are depressed the rational brain has less control over our feelings than the primitive emotional brain. You should try to concentrate on and gain knowledge of your negative thoughts.

As you record your thoughts try to become aware of the types of thinking you are employing.

See Distorted Thinking.

Get as much practise as possible at recognizing and challenging your thoughts. Look closely at your negative thought monitoring record. Which type of negative thinking is each thought an example of? Note the sort of thought you are using and how to challenge it by being rational and compassionate.

Notice the types of negative thoughts that are entering your mind. Identify and question the validity of the thoughts as they do. How might you assist a friend to challenge one of these types of thoughts (e.g. jumping to conclusions)? Be kind to yourself and take a middle view rather than extremes. Concentrate on your abilities rather than what you are incapable of doing. Ask ‘In what way am I taking care of myself?’ ‘Are my thoughts assisting me in this?’ Gradually increase your perceptions and understanding.

To help you focus on controlling negative thoughts use flashcards with the thoughts and alternatives. On one side of the card write down one of your negative thoughts and on the other write down some key challenges to this. If you can identify your feelings but not your thoughts, give your feelings a voice – what would they say? Sit in a mediator chair opposite two chairs placed together which are your internal bully and your inner helper or rational compassionate self. Ask yourself what each would say respectively and write down your thoughts.

When you are depressed your internal images are often gloomy. Try to change the images so that they become more comforting and healing. You could try exaggerating your thoughts and images to put them into perspective. Also, imagining a worse alternative to your feared image can be helpful in making the latter a means of escape instead.

You can face your fears using the Critical Decision Technique (Aaron Beck), which states that your best decision in an anxiety situation is to do the exact opposite of your instincts (e.g. when you want to protect yourself, try making yourself vulnerable). You may be able to gain more control of your feared situation by approaching it as the preferred choice, rather than something you ‘should’ do.

Explore some of your fundamental values and attitudes. Think about those that are no longer useful and try to change them by considering what values and attitudes you would convey to someone else. These will probably be your authentic values and attitudes.

‘Life scripts’ or typical roles give us all an identity. Your life script is a set of decisions you made for yourself in childhood (pre-verbal). The set of decisions you made in later childhood (post-verbal) is known as the ‘Counter script’. When a person says ‘You’ and means ‘I’ then what follows is from their counter script. If you identify a life script that you would like to change, consider what you have to do to achieve this and how you would act differently if you had different values. Deal with the problem in steps.

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  Distorted Thinking        

  CBT model:

Situation [Event/Environment] => Thoughts [Cognitions/Beliefs] =>

{Mood [Emotions/Feelings]

Physical Reactions [Bodily Sensations/Physiology]

Behaviour [Actions/Lack of actions]}


‘What went through my mind?’ (NOT ‘What was I thinking?’)

‘What did that mean to me?’

When you put a ‘that’ after ‘I feel’ you have gone from your emotions into your intellect (beliefs, ideas).

Emotions can often be described in a single word (e.g. anxious, sad, and happy). Whereas thoughts and images are usually described in the form of a sentence. We do not see an emotion/feeling state (e.g. anxiety); we see only the behaviour from which we infer the emotion. ‘Affect’ is the way one relates to and shows emotion; visible mood and emotion.

Change thoughts reported in the form of a question, into a statement, for example, ‘Does he like me?’ to ‘He does not like me’. We tend to blame external events or others for the way we feel. But consider the model:

[A = activating event, B = beliefs or thoughts, C = emotional, behavioural and physiological consequences].

Although events at (A) can contribute powerfully to your emotional problems, it is your beliefs and thoughts at (B) that determine how you feel at (C). It is (B) your evaluation of the personal significance of the event (A), which causes you to experience an emotional/behavioural/physiological reaction (C) to the event.

[A => B => C]

Negative automatic thoughts (NATs), can be images, daydreams and fantasies which pop into your mind involuntarily. They seem plausible at the time of occurrence and are difficult to ‘turn off’.

Negative automatic thoughts associated with depression, anxiety and anger tend to have three major themes, concerning perception of the self, others (world) and the future. This tripartite relationship is known as the Cognitive Triad.

Depressed people see themselves as worthless, the world as punishing, and cannot see the future improving.

Anxious people see themselves as vulnerable, the world as chaotic/threatening, and their future as unpredictable; they also overestimate threat and underestimate their coping resources.

Angry people see themselves as being treated unjustly, the world as hostile, and sense a need to protect self from future harm.

Challenge your NATs by disputing or questioning your upsetting thinking.

Socratic questioning:

What is the evidence for and against my AT (Automatic thought/image)?

How persuasive would this evidence be to others?

What is another way of looking at the situation or the evidence?

If a friend were in this situation or had this thought, what would I say to them?

What is the worst that could happen here?

What is the best that could happen here?

What is most reasonable to expect?

What constructive action could I take to improve my situation?

What are the advantages and disadvantages of my AT (Automatic thought/image)?

What is the effect of modifying my thinking?

There are three levels of beliefs [Tree Analogy]:

Automatic Thoughts – these just pop into your mind involuntarily: [Branches].

Conditional Beliefs/Assumptions – rules [for living] that guide our daily actions. Usually expressed in terms of ‘should’ ‘should not’ (rules) and ‘If…then…’ statements (assumptions). Change the former to the latter to make the distortion clearer: [Trunk].  

Core Beliefs/Schemas – absolute/dichotomous statements about yourself, others (world) or the future; usually formed from childhood experiences: [Roots].

Automatic thoughts ensue from maladaptive assumptions which in turn are a result of core beliefs. Thinking affects your feelings and how you feel affects your behaviour. By altering your thoughts you will feel better and your behaviour will change.

The way you think about something will determine how you feel, and the way you feel will often determine what you do.

There are three main themes of irrational beliefs:

Needing to be successful/fear that one is inferior.


Needing to be liked by others/terrified of rejection.


Needing to always feel in control/fear of being dominated by others or by events outside of one.


There are four common unhealthy beliefs:

Rigid Demands (‘Must’ ‘should’ ‘always’).

Depreciation (Putting down yourself, others or life conditions).

Awfulizing (It’s terrible that…’).

Discomfort Intolerance (Low frustration tolerance – ‘I can’t stand it that …’).

Healthy alternative beliefs are:

Full Preference (I don’t want to feel discomfort but there is no law of the universe that says I must not feel discomfort).

Full Acceptance (Accepting yourself and others as fallible human beings and that while you would prefer life to be good to you it can be a mixture of good, bad and neutral).

Anti-Awfulizing (It’s annoying but not the end of the world that…).

Discomfort Tolerance (High frustration tolerance – ‘I can stand it that…’).

Full Preference asserts preference AND negates demand (e.g. [I would prefer it if I played well at tennis] [BUT there is no reason why I MUST do so]).

Full Acceptance is of the form: [I am not X…] [BUT I am Y] (e.g. [I am not worthless for failing my exams] [BUT rather, I am a fallible human being with good, bad and neutral aspects]).

Consider each unhealthy belief and the healthy alternative and ask:

The empirical question – which belief is true and which is false?

The logical question – which belief is logical and which is illogical?

The pragmatic question – which belief leads to largely healthy results and which leads to largely unhealthy results?

It is the high intensity distressful evaluations which are extreme and unrealistic exaggerations that you need to modify (i.e. ‘hot thoughts’).

Analogies can provide you with a different perspective (e.g. when you demand that other people must treat you exactly as you want them to). Suppose that I want to be rich and I demand to have the world’s largest diamond appear in my hand, at this very moment. ‘I must have it, I must, I must, I must’. You can easily see that to demand this would be foolish, but this analogy shows that you are making a similar unrealistic demand when you insist that people must treat you as you want them to. There is no law of the universe that states something ‘MUST’ or ‘MUST NOT’ happen because we demand so.

The self is ‘every conceivable thing about you that can be rated’. Human beings cannot legitimately be given a single global rating. Consider Big I/Little i: Draw an outline of a Big I and fill it with lots of little i’s – the little i’s represent aspects of self and are limitless. Mistake is to think some of these little i’s represent the self (Big I) – this leads to being self-critical. Focus on the little i’s and accept you as a fallible human being.

Human beings are essentially fallible. To see that it is an error to call you a ‘failure’: Draw three circles and fill the first with crosses; the second with small circles; the third with a mixture of crosses and small circles. The first represents a person who is a ‘complete failure’ – do you fail at everything? The second represents someone who is ‘perfect’ – do you succeed at everything? The third represents a person who is ‘human’ – do you have a mixture of successes and failures?

To deal with negative thinking:

Identify and record unhelpful thoughts.

Challenge unhelpful thoughts by evaluating these (i.e. detecting thinking biases – see below). Suggest rational alternative thoughts. Write an action plan of the strategies to use to help you break old habits of thinking and strengthen new ones.

To change unhealthy beliefs you need to ACT against them, then act in ways consistent with your new healthy beliefs to internalize these healthy alternative beliefs.

Point-Counter Point Technique:

Use the Point-Counter Point Technique to deal with negative thinking. Start with an irrational thought in the first column then counter it with a rational alternative in the opposite column. Elicit another irrational thought and then counter with a rational belief in the respective columns. Continue in this way and end with a rational thought.

Dysfunctional Thought Record:

Use a Dysfunctional Thought Record (DTR) to modify biased thinking:


Column one: Activating event [A] – describe actual or anticipated event (Who? What? When? Where?)

Column two: Dysfunctional belief [B] (thoughts/images) about [A].

Column three: Functional alternative belief [B] (thoughts/images) about [A].

Column four: Dysfunctional consequences [C] (emotions/physical reactions/behaviour) of dysfunctional [B].

Column five: Functional alternative consequences [C] (emotions/physical reactions/ behaviour) of functional [B].

Note credibility of dysfunctional B (0-100%) and intensity of dysfunctional C (0-100%). Next, dispute dysfunctional B with a functional B and write the functional C. Rate credibility of functional belief and intensity of functional C.

To keep track of your progress with your unhelpful thoughts, record for at least eight weeks:

How strongly you believe the unhelpful thought (0-100%).

How distressful you find it (0-100%).

The approximate number of times a day you think about it.

Plot the above ratings on the y-axis of three separate graphs with the week numbers on the x-axis. You should find that you get a pattern of decrease with time for each of the three graphs.

Worrying thoughts become a difficulty when you cannot get rid of them easily. A cycle of mounting anxiety can result if you do not identify and challenge your worrying thoughts. Ask yourself if your worry is irrational and unrealistic. If so then find a rational statement to replace it.

There are five steps to challenging worrying thoughts:

Identify your worrying thoughts – try to catch the thoughts that go through your mind.

Monitor your thoughts when you are anxious each day. Note the date and time and your anxious thought. Rate it 1-10 (1 is no distress and 10 is most distress).

Write down thinking biases.

Form new helpful beliefs and strengthen your conviction in these new beliefs.

Re-rate your distress.

Subjective Units of Discomfort Scale (SUDS) ratings [0 (no anxiety/distress) to 100 (worst anxiety/distress ever experienced)] can be used to monitor anxiety change with time in exposure, and can be plotted on a graph with the SUDS on the y-axis and time on the x-axis. It is often the case in exposure that the SUDS ratings start high but decline over time, showing that the hardest part is getting started.

Patterns of biased thinking:

You need to recognize bias in your thinking so that you can rectify your thoughts. Patterns of biased thinking include:

Personalization – being personally affected by things; assuming full responsibility for bad events even when blameless.

Mind-reading – thinking you know someone’s thoughts when you do not.

Mental filter – focusing on negative detail and not seeing the whole picture.

Discounting the positives.

Jumping to negative conclusions – interpreting things without evidence.

Emotional reasoning – taking a feeling as evidence of fact.

Catastrophizing – predicting the very worst.

Overgeneralizing – making global conclusions from one or more events.

Predicting the future.

Labelling – calling you names without evidence to support it.

Wishful thinking.

Dichotomous thinking (all-or-nothing, black-and-white thinking) – seeing two extremes only, instead of a continuum.

Tunnel vision – seeing only the negatives in a situation.

‘Should’ and ‘Must’ statements – you have inflexible expectations of how you, others (world) or the future should be.

Selective abstraction – attending to material that supports one’s original assumption.

Arbitrary inference – an inference that leads to the realization of what one has originally feared.

Self-fulfilling prophecy – you unintentionally create a real situation that reconfirms your basic assumption about yourself.

Misattribution – you may attribute the problem to the wrong cause.

It is possible to successfully challenge all the above biased thoughts. From the different types of negative thinking given above try to recognize the ones relevant to you. Consider how you can challenge your worrying thought by finding alternative ways of thinking. Think about the advantages and disadvantages, also the evidence both for and against maintaining the worrying thought. What is the worst-case scenario and how could you cope? Try to form a more rational and constructive view of the circumstances.

Continuum Method:

To deal with all-or-nothing thinking, draw a line with two extremes at opposite ends of the line (e.g. 100% failure to 100% successful). Mark on the line where you think you fall. Next, mark where you think significant others would fall. Finally, mark on the line where you think you fall now.  

Negative core beliefs formed in your early life lie dormant until activated when you are upset. After an emotional crisis they return to their dormant stage. Unless modified and changed they will remain ready to be reactivated during emotional crisis. Examples of core beliefs/schemas are: Helplessness/Powerlessness, Worthlessness, Unlovability, Subjugation, Self-Sacrifice, Abandonment and Mistrust schemas.

Uncover negative core beliefs using the Downward Arrow Technique.

For example, you may be anxious about a party:

‘I won’t get on with anyone’ => If that’s true what would it mean to me?

‘I’ll leave alone’ =>If that’s true what would it mean to me?

‘No one finds me attractive’ => If that’s true what would it mean to me?

‘If no one finds me attractive, then I’ll be all alone’ (underlying assumption) =>If that’s true what would it mean to me?

‘That I will never find a partner’ (core belief – this usually takes the form of a universal rule for living such as ‘I must succeed in virtually everything I do or else I am a worthless human being’).

The above technique can be used to find core beliefs about other people or the world, using the question ‘What does this say or mean about other people?’ or ‘What does this say or mean about the world?’ respectively, instead of ‘If that’s true what would it mean to me?’

Once you have revealed a core belief consider the biased thinking you are using and use Socratic questioning to modify your belief.

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                  Thought Management Procedures

The following strategies will provide temporary relief and give you confidence in your ability to control mental events:

Thought Stopping – when an obsessional/disturbing thought occurs, shout ‘Stop’ to clear your mind. Reduce the volume of the shout in increments until just thinking the word ‘Stop’ clears your mind. You could snap an elastic band around your wrist as you shout ‘Stop’.

Thought Control – dismiss your obsessional/disturbing thought by using the Thought Stopping procedure or another form of mental distraction, then try to re-obtain the dismissed thought. This procedure will show that you do have control over your own mental processes.  

Thought Switching – bring to mind your obsessional/disturbing thought then immediately switch to a positive thought.

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                  Self – Instructional Training

Imagine being in the problem situation and identify what thoughts are running through your mind just as you start to feel anxious:

Identify self-defeating and stress-inducing self-statements.

Generate rational coping statements and write these on a flashcard.

Rehearse these rational answers before entering the situation, during the situation and afterwards.

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                  Strengthen Conviction in Alternative Functional Beliefs

Once you have established a new rational belief, test it out using imagery then behavioural experiments. Imagine or take action (behaviour) that contradicts the negative thinking, for example, if you fear:

Rejection – try asking for a date.

Perfectionism – try deliberately making a mistake in something that does not matter too much.

Panicking – try to gradually expose yourself to situations where you may panic.

Procrastination – do the activities you are putting off.  

Trigger Review – Repeatedly think about your anger trigger/aversive situation, while remaining calm. Use relaxation and/or rational statements to aid you.

Verbal Exposure – Write down negative words or statements which stimulate common anger/anxiety (aversive) triggers. Get a trusted friend to repeatedly read these out to you and keep your composure.

Imagine yourself in the problem situation and practise your new realistic thinking to cope with your distress and end by visualizing a positive ending. Drop any safety behaviours: Response Prevention – reducing and stopping rituals and any other safety precautions that you adopt.

See Imago Graded Exposure.

It is more powerful in modifying negative beliefs, to expose yourself to problem situations and use your rational thinking to cope with your distress. Drop any safety behaviours: Response Prevention – reducing and stopping rituals and any other safety precautions that you adopt.

See In Vivo Graded Exposure.

There are three factors that maintain negative behaviour. These prevent you from finding out that the dreaded catastrophe does not occur:

Selective attention – (e.g. discounting the positives and hyper-vigilance – noticing bodily changes that otherwise would not be noticed, and accepting this as further evidence that something is wrong).

Avoidance – avoiding circumstances that trigger the problem (e.g. anxiety).

Safety behaviours – these are what a person does or avoids to prevent their predicted catastrophe (e.g. an agoraphobic: keeping within distance of a safety person/friend or hospital; being able to make frequent calls to spouse; carrying medication [just in case] or large sums of money).

You need to:

Act ‘As if’ the new belief is true.

List evidence supporting the new belief.

Continue to rate conviction in both old and new versions of the belief on a daily basis.

Record instances of living by the new belief.

Carry a flashcard with the new belief, as a reminder.

Rational Portfolio Technique:

Take one of your irrational beliefs and the healthy alternative to this belief. You will need two separate sheets of paper. Write the heading ‘Irrational Belief’ on one and ‘Rational Belief’ on the other. List as many arguments as you can against the irrational belief and as many arguments as you can to support the rational belief, on the respective sheets of paper.

Attack-Response (Zigzag) Technique:

Write down your rational belief: Note your level of conviction in it 0-100 (where 0 is no conviction and 100 is total conviction). Next, strengthen your conviction in it by attacking it with irrational arguments and responding to these arguments with rational rebuttals until you cannot think of any more irrational arguments. Re-rate your level of conviction (0-100).

The Devil’s Advocate:

This is an alternative way to carry out the Attack-Response Technique with a friend who makes the attacks and you respond rationally to the attacks until there are no more irrational arguments.

See Behavioural Principles and Summary for Cognitive Behavioural Change.

[End of Modifying Maladaptive Thinking].

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                  9. Behavioural Principles

Positive reinforcement [Something is added] – an action that is rewarded will be repeated more often. [A positive gesture can lead to a positive gesture in return, and a more fruitful relationship can result].

Negative reinforcement [Something is subtracted] – an action that leads to something noxious being removed will be repeated more often.

An action that is ignored (extinguished) tends not to be repeated. [Ignore behaviour (extinction) and try to encourage an alternative positive action which is incompatible because they cannot do it at the same time].

An action that is punished is interrupted, but may be repeated or not in an unpredictable way. [Punishment involves giving attention and this is valued even if it is negative attention so the unwanted behaviour may continue so as to increase the punishment (attention)]. Punishment can be positive or negative (i.e. something is added or subtracted respectively).

Reinforcement can be either:

Continuous – occurs in a predictable way; regularly.

Variable/intermittent – happens at random; is unpredictable.

Behaviour patterns reinforced regularly are easier to change than behaviour patterns produced by a variable reinforcement schedule.

Deal with worry or jealousy by setting a specified time daily to discuss/contemplate the matter and limiting such discussion/contemplation to only this planned time.

Avoid rash decisions (especially when hypomanic) by using: 48 Hour Delay Rule, Third Party Advice, and do more ‘sitting and listening’ rather than ‘stand and talk’.


When in a risky situation, the immediate goal is to prevent further damage. In such circumstances, avoidance (stimulus control) or escape manoeuvres, may be applicable, but only as an early and temporary measure to control anger/distress and allow time to develop long-term coping strategies.

Six behavioural techniques are:

Graded Exposure.

Using a hierarchy of problem scenarios.

See Trigger Review, Verbal Exposure, Imago Graded Exposure and In Vivo Graded Exposure.

Response Prevention.

Dropping safety behaviours while exposing yourself to anxiety provoking situations, so you can learn that your predicted catastrophe does not occur.

Systematic Desensitization.

Practising relaxation while exposing yourself to anxiety provoking situations.

Introceptive Exposure/Desensitization.

Symptoms of a panic attack are induced in order to promote coping skills and show the patient that no harm can come from a panic attack.

Systematic Resensitization.

Practising relaxation while exposing yourself to previously enjoyed activities until pleasant feelings are regained.

Anticipation Training

Negative anticipations are modified by constructing positive anticipation statements for scheduled activities which are initially rehearsed in imagery.

For Introceptive Exposure/Desensitization, symptom inductions may include:

Intentional hyperventilation – creates dizziness, blurred vision.

Spinning in a chair – creates dizziness, disorientation.

Straw breathing –creates dyspnoea (painful breathing).

Breath holding – creates sensations of being out of breath.

Running in place – creates increased heart rate.

Body tensing – creates feelings of being tense.

Frightening symptoms are induced and the patient learns to gradually tolerate the sensations. The process by which you get accustomed to repeated anxiety causing events is called ‘habituation’.

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                  10. Summary for Cognitive Behavioural Change        

You need to be motivated and deal with any ambivalence. It can help to list the costs and benefits of change and consider how your life may be in five years:

If you do not change.

If you do change and overcome your problem.

Activity Monitoring:

Monitor your problem (e.g. eating, drinking, smoking, depression, anxiety, anger, stress, sleep).

Keep a diary to identify your current behaviour and triggers for the problem. A daily activity schedule showing the level of achievement-mastery and pleasure gained from planned activities can enable you to make the best use of your time.

Write down the changes you desire, your reasons for wanting the changes, the steps required to attain them (cognitive restructuring, emotional, behavioural and physiological change), how other people can help and any obstacles to the changes. Finally, consider how committed you are to changing. Is this what you really want to do? If you lapse remember that there is no failure only feedback, and learn from the setback. Renew your motivation and commitment by reviewing your reasons for change and your progress so far.

Thought Monitoring:

Frequency/duration/content/credibility/intensity-level of distress, of:

Dysfunctional and functional, beliefs (cognitions) and consequences (emotional/behavioural/physiological) in trigger situations – can all be monitored.

Use a Dysfunctional Thought Record (DTR) to change dysfunctional thoughts, emotions, behaviour and physical reactions to functional alternatives. Use appropriate coping strategies. Strengthen conviction in new helpful beliefs and maintain emotional, behavioural and physiological change.

Use Cognitive Methods to support Exposure and Response Prevention.

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                  11. Planning an Activity Schedule

An Activity Schedule can reduce helplessness and hopelessness by establishing a consistent pattern of planned activity, rest and regular sleep routine.

If your activity level has reduced greatly you need to plan an activity schedule to increase activity.

If you generally do too much your activity schedule needs to decrease activity.

Using your activity and sleep diaries for guidance build your activity program covering each hour of the day for each week. Try to get a balance between work, chores, rest, socializing and pleasurable activities. When planning either schedule try to break down the tasks into manageable chunks (e.g. cleaning one hour on one day a week to cleaning twice a week for thirty minute periods). Try to have the same amount of activity and rest each day. Record your progress in your activity and sleep diaries.

Rate each activity 0-10 for mastery (M) (M0 is no achievement and M10 is most achievement). Similarly rate each activity 0-10 for pleasure (P) (P0 is no pleasure and P10 is most pleasure). Note how these ratings change as you progress.

Review your schedule every week to assess progress and make any required changes. When your activity level becomes consistent you can consider increasing or decreasing gradually your daily activity and increasing your pleasurable activities.

The Activity Schedule can also be used to monitor other symptoms (e.g. rating degree of anxiety or low mood) using a scale of 0-10. This can identify which situations/activities you find most distressful. Remember the emphasis is always on attempting the task and not on its successful completion.

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                 12. Forgiveness

Forgiveness if unresolved can lead to increased bodily stress and medical problems in the long-term. In order to forgive you need to separate the offender from the act. A person may commit an evil act due to biological and environmental forces but that does not make them a totally evil person. You need to stop ruminating on the injustice that has occurred and accept it (i.e. recall what happened without desiring revenge), otherwise you will suffer unnecessarily. Forgiveness is the minimization of both resentment and the desire to seek revenge (lower reactivity) while feeling empathy for the offender.

When angry you will be preoccupied with the past, so cannot enjoy the present and keep the role of ‘victim’. Forgiveness means living in the present and developing compassion for the offender without sanctioning their behaviour. Reconciliation and forgiveness are crucial after a disagreement. You may have certain beliefs that prevent this – explore them and try to alter them.

Focus on the meanings in your anger in order to be assertive. Concentrate on the hurt and important topics causing the disagreement rather than self-attacking or hitting out. Guilt, sulking, aggression and fearful retreating are all non-assertive behaviours to be avoided. Try not to get angry with yourself for lack of assertiveness. This way you will stop your internal bully from taking control. Forgiveness is assertive behaviour. You set yourself free from feeling victimized and wishing to avenge yourself.

Think about examples of assertive behaviour. Avoid attacking the other person. Clarify what you want to say and concentrate on a particular topic. Be willing to make exchanges and reach settlements by concessions on each side. This should not be seen as being weak. Try rehearsing what you want to say. This can be more productive than hasty action when angry. If you have a problem of self-directed anger, practise saying assertive things to yourself.

Give yourself time to think in an argument. You could ask the other person to expand on their worries rather than rushing to take the defensive. Acknowledge the other person’s view then give your own factual version. Try to avoid attacking each other.

Spend time forgiving others and live in the present, not the past. Note the pros and cons of this and how it would help you. What is hindering you? Employ your rational and compassionate self to find alternatives to your negative beliefs. If you feel unable to come to terms with your hurt you should seek help.

Try the Buddhist ‘loving kindness’ meditation. Go through a simple relaxation exercise to calm your breathing then imagine yourself as a person who needs loving kindness.

See Controlled Breathing and Relaxation Techniques.

Visualize yourself lying there with loving kindness directed at you. Let go of bad feelings and forgive yourself. Next, imagine loving kindness directed at others. If they have hurt you, visualize forgiveness for them. This does not mean you should condone their behaviour but release yourself from damaging feelings.

‘The stupid neither forgive nor forget; the naïve forgive and forget; the wise forgive but do not forget’.

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                  13. Frustration

Frustration occurs when one is prevented from reaching a personal goal. Disappointment can be caused by things such as our feelings regarding our private life and obstruction to life goals. When our ideals are unrealistic we can be set up for disappointment. The frustration caused by disappointment frequently leads to thoughts that attack yourself (your internal bully) or others. You need to recognize these thoughts and challenge them. As frustration increases you are likely to use types of negative thinking (e.g. all-or-nothing thinking). Try to set a boundary to the effects of disappointments on yourself so that you are not propelled into depression.

Make two columns – one for ideal thoughts and the other for actual thoughts. Write down these thoughts the last time you experienced anger and disappointment. Next, note any thoughts created by this disappointment that attack yourself, then any that attack others. Consider if you use any types of negative thinking (e.g. disregarding the positives, overgeneralizing).

See Distorted Thinking.

How would you advise a friend who has suffered this disappointment? Is there evidence to support your ability to deal with this successfully? Do not overlook problems where you fail to differentiate between your behaviour and your ‘self’. Examine the compelling force of ‘should’ and ‘must’ behaviour in your life. Does it create more pain? If so consider how it does so. Are you ashamed at not attaining your ideals and hence, feel disappointed? Most importantly ask yourself, are your ideals realistic?

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                  14. Competitiveness and Perfectionism

Most of our problems arise from failing, so learning how to fail without attacking yourself is useful in gaining more control over your mood. Without realizing it, because of the pressure to succeed, we can become competitive and perfectionist people who are daunted by the thought of failure. Perfectionism leads to frequent disappointments which can result in depression.

Perfectionism can lead to competitiveness when we want to be seen as superior and wish to avoid inferiority. It is necessary to work cooperatively versus competitively. To find out in which areas of your life your competitiveness lies ask yourself which areas of your life you would not settle for being average and which concern you regarding what others possess, are achieving or doing.

A problem with perfectionism is that you evaluate yourself on the products of your activities and disregard your efforts. Competitiveness and perfectionism can be directed at ourselves or others or we may feel it is expected of us.

Another problem with competitiveness and perfectionism is that your internal bully directs frustration and anger toward yourself. You may become self-centered from perfectionism and competitiveness if you let your inner bully take control. Perhaps you experience frustrative anger, anxiety or guilt at not succeeding, because of your thinking styles. As a result self-attacking or attacking others may increase, leading to you feeling more depressed/low.

Consider how you cope with yourself and others when you do not meet your ideal standards. In order to identify your competitiveness and perfectionism think about an occasion when you did not succeed at something. What were your ideals regarding the matter? What were you hoping to achieve? Why would that have been good? Were you afraid of inferiority or were you seeking superiority? Were you attempting to attain your own ideals or those dictated by others? Was your objective to gain the favour of others? Are you success orientated or do you try to avoid failure?

Praise yourself for even your little successes. Examine your actions when you fail. Do you attack yourself or others? What do you say in these circumstances? Do you accept failure, if so why? Write these down to make things clearer for yourself. Next, explore if you use types of negative thinking (e.g. all-or-nothing thinking).

See Distorted Thinking.

Learn how to fail so that you need not fear achieving success. Use your rational and compassionate mind to ask yourself firstly, how you would advise a friend, and then what you wish them to say to you. Can you find alternatives to challenge your negative thoughts and feelings?

Try to break things down into a manageable size and proceed in steps concentrating on your achievements rather than what you have been unable to do. Set realistic standards, become tolerant of others’ mistakes and learn to identify what is ‘good enough’ and accept it. Realize that perfectionism is illogical and unrealistic.

Is your life pleasurable or do you not enjoy things? Can you complete one task today? Consider how you might obtain help from others. Learn to accept yourself thus, gaining confidence and enjoy your success.

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                  15. Troublesome Emotions

When dealing with troublesome emotions remember that change will occur when you think and act differently.

Anger, Anxiety and Depression are dealt with in:

Program 6: Overcoming Anger, Program 8: Overcoming Anxiety, and Program 12: Overcoming Depression.


Shame is about who you are. You believe that you are bad and essentially unlovable, inadequate, inferior, or in some way different. Shame is caused by violation of cultural or social values. We are all capable of developing shame. Shame occurs when we devalue ourselves for behaving in a way which attracts disapproval or ridicule. When ashamed you may see yourself as diminished, defective or socially repellent. You may feel shame or be shamed by others. Shame has emotional, behavioural and physiological components. These feelings may have been established in the past or present.  

When you label yourself as (e.g. inferior or bad), your shame increases. Shame is when we want to feel good about ourselves but others will not allow this. Your inner bully can make you feel shame and it is a bad idea to be restrained by your bully. Shame can bring you to a standstill and you may spend much of your life hiding it or compensating for your shame.

In order to beat shame you need to admit the truth of the root of your shame with compassion for yourself and acknowledge that types of negative thinking (e.g. all-or-nothing thinking), control the functioning of shame. Write down the things you feel ashamed about and use your rational and compassionate mind to challenge them by finding alternatives to the shameful thoughts. For example: ‘I am NOT a worthless person because ….’

What is occurring when you feel ashamed? Imagine a friend is assisting you – take their compassion and request what you require of them. How can you change to overcome your shame? How would you act if you felt less shame? Contemplate measures to realize this. Your fear of other people’s opinions will be reduced as you try to alter your behaviour. For example, if you are dependent on wearing make-up to go out, try not wearing any. Examine and challenge your thoughts.

Shame attacking exercises can help to change your shame producing ideas. In these exercises you engage in tasks which invite criticism and public ridicule (e.g. asking for directions to the hospital when standing outside it) while at the same time having self-acceptance for your behaviour, for example: ‘People may laugh at me when I act silly but this does not mean I am a silly person’. Ensure you do not break the law or put yourself or others in danger with your chosen exercises.

You need to tolerate the anxiety caused by these exercises and forceful coping statements will help you remain in the situation. You will learn that it is the meaning you attach to the criticism and not the criticism itself that causes you to feel shame. You can use these exercises as a rehearsal before implementing them to areas of your life in which you wish to make changes.

See Criticism and Countering Self-Criticism.

Attempt to be less formal with people. Increase your warmth toward them and concentrate less on what is visible. Be the initiator in developing positive activities with other people. You could try joining a group such as Alcoholics Anonymous – the self-empowerment skills they will teach you will be invaluable.

Keep a journal of your feelings of shame – this will give you emotional release. Try to understand the child in you; accept and love that child. Tell yourself each day about one good quality you possess. Do not listen to the shaming voice in your mind. Recognize, stand up to or avoid people and situations that trigger your shame.  

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Guilt is about what you have done. It comes from thinking, feeling, or behaving in a way you believe is wrong or bad. Guilt occurs when we think we have failed to live up to or transgressed a moral rule, or hurt the feelings of a significant other. It results from the violation of internal values – we think we have done something wrong. Distress ensues at having done something one believes one should not have done (or, not doing something one believes one should have done). Guilt arises from a responsibility for others. We focus on the harm or hurt we may have caused other people. It is often connected to fear and sadness. When we feel guilt we tend to view ourselves as immoral.

Normal guilt occurs when we think we have done something wrong and pathological guilt occurs when we have the additional belief that as a result we are a bad person. We may deny ourselves pleasure or resort to self-punishment because we feel that we deserve to be punished since we are a bad person. A common form of self-punishment is self-blame where we blame ourselves entirely for problems. We may take self-blame further and self-harm.

The problems of life naturally cause guilt which can restrain us but on the bright side, can enable us to acknowledge our damaging behaviour. Guilt can trigger self-attacking and shame. Guilt occurs when we feel we have not dealt adequately with people, had to turn down their requests or suffered a separation. If you suffer from guilt you may think you are a burden or feel you have disappointed others – note you do not choose to have your emotional problems. If your guilt makes you feel suicidal, seek professional help.

Try to recognize your key guilt areas. Let us consider how guilt can be both beneficial and detrimental to your well-being. Write down the ways in which recognizing your guilt helps you. Then think about the ways in which it is not of aid.

Confront and challenge your guilt by asking yourself the following questions: What am I trying to achieve by endeavouring to be pleasant? Am I taking on too much responsibility? Is this something I learned when young and need to alter now? What made me think this way and how might I alter my behaviour? Does my guilt make me submissive and unable to assert myself for fear of what others might think? What evidence is there for and against my guilt? What are the alternatives to my negative thoughts about guilt? What advice would I give a friend experiencing the same circumstances? How can I reduce and control my guilt?

It can be helpful to write a review of how you think you may have acquired your guilt and what you could do to challenge your guilty thoughts. List the advantages and disadvantages of feeling guilty in a given situation. How does guilt benefit your life? How is it detrimental to your well-being? List all the factors that contribute to your problem. Redistributing responsibility (also known as Reattribution) can help you to tackle guilt. List all people relevant to the event and give each a percentage responsibility, with yourself last – the total should not exceed 100 per cent.

A simple ritual to counter guilt is to find a small box and write on it the address of the person pressurizing you, and your own name and address in the centre. For a week note any inappropriate guilt inducing statements you experience, on separate pieces of paper, placing them in the box. Next, write on the box in large letters: RETURN TO SENDER. Then dispose of the box in any way that makes you feel good and is safe.

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Jealousy results when something or someone you believe belongs to you is lost, either in your imagination or in reality. Romantic jealousy arises from an actual or imagined threat to your relationship from a rival. Morbid jealousy occurs when there is an irrational pre-occupation with your partner’s fidelity for which there is no foundation. You view your partner conversing with the opposite sex as evidence of infidelity. You may fear that you no longer have your partner’s exclusive attention and that they will ‘desert’ you. As well as jealousy you may feel anxiety, depression and anger.

It has been suggested that it is distrust of yourself – feeling inferior to rivals, which causes your jealousy rather than distrust of your partner. When morbidly jealous you may behave in a manner which drives away your partner. You may constantly seek reassurance, check for infidelity, accuse your partner of unfaithfulness, monitor and restrict your partner’s behaviour.

In mild or moderate jealousy a threat to your relationship exists in your opinion but you react by investigating what may be wrong with the relationship and dealing with it constructively.

In the event of infidelity – should you wish to remain in the relationship you need to make clear to your partner what behaviours you expect from them and the consequences should they ‘relapse’. If you are rejected by your partner you need to remember that you are the one who evaluates yourself and should not feel your worth as a person depends on being loved.

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Hurt ensues when you consider you have been betrayed or let down by a significant other. You feel hurt due to perceived injustice done against yourself (e.g. assumed betrayal that you conclude is undeserved). Self-pity, depression and anger can be combined with hurt. When hurt you may withdraw into resentful silence and sulk. Your sulking may be silent or angry and intended to punish your partner/significant other, but avoid a head-on confrontation.

You need to establish the FACTS of the situation and not base your hurt on your interpretation of the circumstances. It is necessary to understand that there is no law which states you MUST be treated fairly and get what you believe you deserve. This realistic view will lead to sorrow rather than hurt and instead of sulking you can assertively communicate with your partner/significant other, to implement desired changes. Time wasted sulking is better spent seeking to improve your relationship with your partner or significant other.

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Envy occurs when you would like to possess what you do not have. To envy is to desire (covet) the good fortunes or advantages of another. The difference between envy and jealousy is that the former involves two people whereas the latter involves three people. Envy can be resentful or non-resentful.

In resentful envy you may find yourself lacking compared to another who has what you want. You may:

Become malicious and devalue the desired possession.

Convince yourself that you do not need it and are better off without it.

Convince yourself that what you have is equal or superior to what is desired.

Convince yourself to get what is desired whether or not it is needed.

Contemplate on depriving the other person of what you desire.

In non-resentful envy there is honest and open expression of your desire without devaluing the other person or the desired possession. You may:

Ask for advice on how to get what you want.

Express support to the other person for getting what you desired.

Sympathize with the other person’s misfortunes.

You want the desired possession so try not to convince yourself that you are happy or even superior without it but make sure your reasons for wanting the desired possession are for your own pleasure and not just to prove you too can have what belongs to the other person. Instead of trying to deprive the other person of what they possess it is more constructive to improve your own position in life.

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Pride results from having a high opinion of oneself and feeling joy for the accomplishments of oneself and others linked to us. It is considered to be one of the ‘Seven Deadly Sins’.

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Embarrassment is an emotional state experienced upon having a socially or professionally unacceptable act or condition witnessed by or revealed to others, leading to loss of honour or dignity.

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Humiliation arises when one is reduced to a lower position in one’s own eyes or in others’ eyes and this is accompanied by a desire for revenge.

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      Healthy and Unhealthy Emotions


You feel (emotion)…about (situation) which leads to…(behaviour). Avoid extreme thinking (e.g. ‘awful’ ‘horrible’ ‘end of the world’). Use words such as ‘bad’ ‘unfortunate’ ‘unpleasant’. You feel the way you think – assume responsibility for your emotional, behavioural and bodily responses to an event. Think flexibly in terms such as ‘desirable’ ‘preferable’ ‘better’… rather than making demands and commands such as ‘must’ ‘should’ and ‘have to’.

You will be happier if you value your individuality and express it respectfully without fearing the reactions of others. Accept that life can be unfair and understand that approval from others is not necessary. Realize that love is desirable, not essential. Develop High Frustration Tolerance (HFT) – learn to tolerate short-term discomfort for long-term gain.

Place your interests first most of the time with a few others a very close second. Of course, there may be times when it is a good choice to place someone else’s needs first. Maximize your happiness by pursuing interests, hobbies, and being consistent with your values. Tolerate uncertainty – take calculated risks and experiment rather than avoidance, reassurance seeking or using safety precautions. You will feel less anxious if you accept that 100% certainty is exceptionally rare.

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                  16. Improving Your Self-Image and Combating Self-Harm

Work on your self-image by making pleasurable activities a priority. Mix with people you like who value you and make you feel good. Try not to compare yourself with just the best looking people and consider the whole person; as good as some people look, we all have flaws. You need to recognize that media images are not accurate reflections of reality.

Make an effort to nourish yourself – do something nice for yourself every day. Try to identify your good qualities. List the qualities you value in others then note the ones that apply to yourself or a friend might say you possess.

Keep a record of the positive things in your life. Note as many positive events, compliments, achievements and qualities as you can; re-read the entries every week and summarize to build your self-image and challenge negative beliefs. Try to focus more on your external environment, rather than looking in from the outside.

To deal with distorted thinking about your appearance:

See Modifying Maladaptive Thinking.

If you do have a defect in your appearance, social skills training can help you manage life with confidence, on a par with those who have no visible difference.

See Social Skills Training.

Prepare a detailed answer, a moderate answer and a brief answer to questions about any visible difference you have and use the appropriate response when socializing. Make the most of your appearance and do not try to hide away.

Learn to solve problems effectively so you have more time to spend on what is important in your life.

See Problem-Solving.

It is advised that you consult a psychologist or psychiatrist before seeking cosmetic surgery.

If you see (self) as worthless and a burden to others (world), feel hopeless about change (future) – you could be at major risk of suicide and should seek immediate medical help. If you feel suicidal or have the urge to harm yourself, identify these feelings and try to understand why you feel this way (e.g. it may be the result of very low self-esteem or distress). Recognize what triggers these feelings so that you can avoid them. Consider what coping strategies you have to restrain your urges (e.g. relaxation techniques or distraction).  

Make a contract, not to harm or kill yourself, with someone close to you. When you feel the urge to harm yourself phone for help instead of following these feelings. Keep a list of important telephone numbers of friends and professionals, close at hand. Do not keep anything you could kill or harm yourself with near you. Keep a written reminder with you close at hand of why you should live and not harm yourself.

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                  17. Coping with the Need for Approval

If you excessively seek approval, the needs of others will become more important than your own. You can become trapped in seeking approval when the means of achieving approval becomes to be increasingly subordinate. You avoid your own needs and try to please others. People can become subordinate to a way of life or to others. Conflict over whether you live for yourself or for others can lead to a loss of identity. This is linked to loss of composure and reduced confidence due to lack of control over where your life is going.

Build your confidence by increasing the positives in your life, be serious about your own requirements and try not to criticize yourself.

See Assertiveness Training, Neuro-Linguistic Programming (NLP), Building Confidence I, Building Confidence II, Building Confidence III and Building Confidence IV.

In your relationships with others remember that approval has to go both ways.

See Program 13: Overcoming Destructive Relationships.

Receiving a lot of criticisms and put downs is linked to mental ill-health. These can be verbal, non-verbal or even physical attacks. You may believe the bully or feel weak if you cannot deal with your adversary but the best option is to remove yourself from their presence or seek help from others.

See Criticism, Countering Self-Criticism and Improving Your Self-Image and Combating Self-Harm.

You will need your Thought Monitoring Record (DTR).

See Modifying Maladaptive Thinking.

Try to recognize the types of negative thinking in the thoughts you note.

See Distorted Thinking.

Use your rational and compassionate mind to challenge the negative thinking.

How do you deal with approval? Are you able to accept nice things said about you? If not, record your thoughts and challenge them. What goes through your mind when you have made an effort and others do not notice? Do you think you are making too much of the circumstances? Are you feeling strongly self-critical? Challenge these thoughts with alternatives.

Do you feel you must please others? What would happen if you did not succumb to the wishes of others? Would you label yourself as selfish? Write down your thoughts and challenge them. What thoughts prevent you from being your own person? Is it possible that your thinking can consider both yours and the other person’s perspective?

Are you blaming yourself for being the target of a bully? Do you believe the bully? If so, think about how you can challenge this and how a sympathetic friend would talk to you.

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                 18. Distraction Techniques

Distraction can block out self-defeating thinking and is useful in situations such as when extremely distressed and unable to implement disputing negative thinking. A cycle of mounting anxiety is set off by alarming thoughts and images. You can break this cycle by distracting yourself:

Physical Exercise: if you keep active you are less likely to be preoccupied by worrying thoughts.

Refocusing: distract yourself by focusing on things around you (e.g. listening to others’ conversations, observing your surroundings in detail using the five senses, studying how someone is dressed or by holding ice in your hands).

Mental Exercise: formulate a phrase, picture or mental exercise that distracts you (e.g. positive statements about the good things in your life; visualizing with the five senses your ‘special place’ where you can retreat to relax; redesign your home; imagine your dream home in detail or recite poetry).

Grounding Position: adopt a position you find safe and comfortable to distract you when distressed.

Comforting Object: distract yourself with an object you carry around with you.

Active Pursuits: divert your attention by going to a movie or a museum, reading a book, drawing a picture, or meditating etc.  

Develop a set of distraction techniques for different occasions that are suited to your needs (e.g. if you get stressed at work then physical distraction may not be helpful/possible). Make two columns – in one write down the situation causing anxiety and in the other, your chosen distraction method. Practise your distraction techniques when you are not anxious and try to catch your anxiety at an early stage.

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                  19. Problem-Solving

Problem-solving can help you deal with life problems which may have been caused by your circumstances such as illness. The problem-solving approach can help you find the most useful coping strategies. You learn to focus your thinking and find solutions to your problem instead of panicking. There are FIVE steps in problem-solving – SOLVE (acronym):

‘S’ State the problem: Be specific and try to break down the problem into more manageable tasks. Do one task at a time.

‘O’ Outline the problem: Specify the initial state and eventual goal.

‘L’ List possible strategies: List solutions; try to write down as many ideas, to solve your problem, as you can. Evaluate the pros and cons of each solution. Consider your solutions and reject the unsuitable ones. List the remaining solutions in order of usefulness.  

‘V’ View the possible consequences and take action: Select a solution and plan action; choose your first solution and decide how you will put it into action. Rehearse your task and make sure you have a back-up plan in case your task does not go as planned. Do it – attempt your solution.

‘E’ Evaluate the effects: Review the result of the solution. If your solution is successful try to understand why it is so. If your solution did not work try to comprehend why it was unsuccessful. Praise yourself for having tried and choose your next solution from your list.

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                  20. Procrastination

Many of us put off doing tasks and find that this is more stressful than doing the job in the first place. Perfectionists tend to be procrastinators. Procrastinators often become emotionally upset by their inability to deal with the problem and due to these emotional problems (e.g. worry and guilt) they are not at their practical problem-solving best.

Procrastination is often safety behaviour to avoid unpleasant experiences but this safety behaviour serves to maintain the underlying problem. You need to see how you are stopping yourself, in order to make changes. Action is more important than motivation and avoided tasks will become bearable when action replaces inaction.

Consider why you put things off:

Fear of failure – you protect yourself by not doing the task, so you will not fail.

Fear of success – you may feel anxious about moving on after a task; achievement may not fit your self-image; others’ reactions to your success may be difficult.

No clearly defined outcome – your motivation to begin and continue will be weak.

To control others – you may like making others wait; the anxiety this causes them and the attention you gain from such behaviour.

For stimulation – you may feel energized by the last-minute rush.

To ‘do it now’:

Remove distractions – what do you do instead of what you should be doing?

Eliminate these distractions.

Break the task down into small tasks.

Commit yourself to small amounts of time.

Tasks may be started anywhere, not necessarily from the start through to the end.

Telling someone suitable what you intend to accomplish will ensure you do it.

Do the worst task first to get it out of the way; alternatively, do it second, after an easy task which puts you in a positive frame of mind.

Usually, it is best to finish what you start but for procrastinators it is better to stop where it will be easy to start again to finish later.

If a last minute rush stimulates you, try finding alternative, more positive ways of challenging yourself (e.g. a new project).

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                  21. Managing Your Time

For good time management you need to optimize your use of time to achieve your values and goals in life.

An acronym to guide goal selection is SMART:

Specific – what exactly is your goal?

Measurable – what will indicate you have made progress?

Achievable – is it reasonable to expect to attain your goal?

Realistic – how committed are you to the goal?

Time bound – can you realize the goal within the allocated time considering your other responsibilities and activities?

Most people work best in the morning but some work best in the evening and you can accomplish more with less effort by allocating important tasks to this time. A short time without interruptions is more productive than a longer time full of disruptions. Also, there are optimum times to socialize (e.g. late afternoons).

Good time management requires being aware of:

Your needs and strengths – list these opposite each other.

Your standard procedure – find out how you use your time at present by keeping a record of how you spend your time. From the record you will be able to work out the best way of working. Try to get a balance of work tasks and include breaks.

Your priorities – identify and rank in order of priority the different areas of your life. Consider the time you allocate to each and what is realistic and necessary. Perhaps others are making demands of you that you need to be more assertive about?

Setting reasonable goals – keep in mind the important areas of your life when pursuing goals. Clearly define your goals so you know you have achieved them. Some goals will need to be broken down into more manageable steps.

Once you know the above you can draw up a new more efficient schedule. Use an organizer and list long-term (within six months), medium-term (within a month), and short-term (within a week) goals. Set aside time each day to organize. Try to do a ‘To do’ list of prioritized tasks every day. Plan flexibly and review every month.

There may be times when you need help from others. It is advisable to delegate when you feel overloaded. Delegating – giving responsibility with authority, to others for appropriate tasks, is part of good time management.

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                  22. Controlled Breathing and Relaxation Techniques

             Controlling Your Breathing

Hyperventilation – faster breathing occurs in response to exertion and stress. In the long-term this can be uncomfortable and cause unpleasant physical symptoms which trigger more anxiety and more hyperventilation. Another cycle of stress is set up and can result in a panic attack.

You can rectify hyperventilation by learning to control your breathing. First practise lying down and later sitting or standing. Place one hand on your stomach and the other on your chest. Breathe in slowly through your nose until your lungs are full then exhale slowly through your nose. Breathing in and out counts as one breath – aim to take 8-12 breaths a minute. Proper breathing involves very little movement of the chest; the stomach moves in and out instead of the chest muscles. In order to be effective you need to practise this exercise repeatedly.



You need to develop relaxation into a skill you can use when you feel muscular tension due to stress. Try to develop a routine and practise your relaxation exercises. Start by lying down and later you can try sitting or standing.

Record your experiences noting the date and time. Rate your distress before the relaxation exercise, 1-10 (1 is tense and 10 is very relaxed). Which exercise did you use? Rate your distress afterwards. Make notes of the sort of day it was, your preoccupations etc. Below are three exercises – only move to the next one when you are fully relaxed after a routine.

First control your breathing then:

Progressive Muscular Relaxation (PMR) [Jacobsen/Deep relaxation]

Breathe slowly and regularly as you focus on different parts of the body: feet – tense your feet then relax and repeat; legs – straighten your legs then relax and repeat; abdomen – tense your abdomen then relax and repeat; back – arch your back then relax and repeat; shoulders/neck – bring your shoulders up and in and press your head back then relax and repeat; arms – stretch out your arms and hands then relax and repeat; face – tense your face and bite hard then relax and repeat; whole body – tense your whole body then relax and repeat.

After the routine if you still feel tense then repeat it, and when you are relaxed think of something calming to relax your mind. Get up slowly and gently. You should practise PMR twice a day until you feel relaxed after the exercise.

Shortened PMR [Quick relaxation]

You can miss out the tensing and go straight to relaxing the different muscles. When you have achieved this you can progress to using the routine at other times and places.

Simple Relaxation Routine [Applied relaxation/Cue controlled relaxation]

Identify a word, object or scene you find calming. Sit comfortably and close your eyes. Be aware of your breathing as you inhale through your nose. As you exhale, think about your calming mental image. Continue this until you feel relaxed. You should practise this exercise frequently.

When you have learned to relax using the three exercises you can start to use the skills throughout the day. Use something to remind you regularly to relax. Apply your relaxation skills whenever you need to use them in response to physical tension.

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                  23. Sleep Management

The length of sleep necessary varies from person to person. Worrying will prevent you from sleeping. You need less sleep as you get older. The average amount of sleep needed is usually eight hours and reduces with age. If you sleep too much, try reducing your sleep at night. Sleep is affected by mood, stress, food, alcohol, exercise and medicines. Daytime inactivity and sleeping during the day can lead you to need less sleep at night. In the long-term, sleeping tablets are not helpful and can be addictive. You can manage your sleep problems by changing your behaviour rather than resorting to medication.

Keep a sleep diary for several nights to ascertain whether you have a problem. Note the date and anything that might affect your ability to sleep (e.g. your activity before retiring). If you have waking episodes, note your activity to restore sleep. Was it helpful? Next day note the number of hours of sleep you managed to get and rate how alert you feel 1-10 (1 is dull and sleepy and 10 is alert). Rate your performance that day 1-10 (1 is poor performance and 10 is performed well).

If you do have a problem the following suggestions might be helpful:

Analyze your sleep diary to see if poor sleep is due to stress and is likely to get better as this eases. Are there behaviours which result in poor sleep that you could change? Identify helpful and unhelpful ways of coping and avoid the latter.

Make your sleep environment comfortable. Introduce pleasant smells into your sleep environment to help you relax (e.g. potpourri or lavender oil). Establish a routine - wake up and go to sleep at regular times and try to relax an hour or two before you go to bed. Keep your daily stress low and seek counselling or the support of friends if you feel the need. Exercise during the day. Avoid caffeine, nicotine, alcohol, and try a warm milk drink before bed. Make sure you are not hungry before retiring as this will keep you awake.  

Ensure you have a quiet bedroom, a comfortable bed and have emptied your bladder before trying to sleep. If you are going to the toilet frequently at night, try not drinking fluids after 9pm. Use your bed only for sleeping and sex. Set an alarm so you wake regularly each day. Avoid naps during the day.

Go to sleep only when you feel sleepy. Get back out if you are not asleep within twenty minutes. Occupy yourself with something that is not stimulating and do not eat or drink at this time. Only go back to bed if you are sleepy. If you are getting up later than 9am, discuss your sleep problems with your doctor. If you sleepwalk you are advised to discuss this with your doctor as it can be dangerous.

Each evening spend twenty minutes writing down any worries and possible steps to resolve them. In this way you may feel more relaxed and get to sleep more quickly. If new worries occur at night write them down to deal with the next day, and allow yourself to stop worrying. Do not force yourself to sleep – try visualizing a pleasant scene until you fall asleep.

To cope with disturbing dreams you could try:

Constructing a positive ending to your disturbing dream and mentally practising this alternative several times before sleeping.

Practising beforehand what you might say if the dream occurs.

Keep water and a towel by your bedside to wash your face with if you wake up sweating – this will help you re-orientate.

Keep a notepad and pencil within reach so you can record your dreams but beware of reading too much into their interpretation.

Relaxed Breathing Method:

You could try the following method of relaxed breathing to ease tension and promote sleep.

Ensure you have some time to yourself and push your worries to one side.

Sit or lie comfortably and close your eyes with your arms by your side.

Concentrate on breathing naturally.

Place your hands on your stomach, breathe in deeply and hold for a few seconds feeling your stomach rise. Breathe out and feel your stomach contract.

Repeat and as you breathe out, think of a relaxing image or sound. Continue doing this until you feel thoroughly relaxed.  

Count back from 10 then open your eyes and feel how relaxed you are now.

Slowly get up and resume normal activities.

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                  24. Exercise

Exercise effectively reduces stress by returning the body to its normal equilibrium, from the ‘fight, flight, freeze or faint’ state of arousal.

There are three types of exercise:

Aerobic exercise – these are vigorous and involve the use of the large muscles in the body, such as the legs and arms. Your cardiovascular system is strengthened and your stamina is increased. Examples are jogging, brisk walking and swimming.

Stretching exercise – these are slow and relaxing and can increase muscle strength, flexibility and joint mobility. Examples are yoga and tai chi.

Toning exercise – these concentrate on firming or tightening specific muscles. Examples are squats for thigh muscles and push-ups for arm and chest muscles.

You need to exercise regularly and adequately. Exercise for 20-30 minutes three times a week is recommended. Be aware to avoid rewarding yourself with fatty foods for increased activity. Also, make sure you drink water before and after exercise, to prevent dehydration.  

Exercise can relieve chronic muscle tension, depression and anxiety. Metabolism will be improved relieving indigestion and chronic constipation. Posture will be improved providing relief for lower back pain caused by stress. Exercise will also fight stress-related chronic fatigue and insomnia. Check with your doctor before starting an exercise program. Start slowly and build up gradually. Select exercise you enjoy.

Make a plan to exercise three times a week for two months and be committed to this schedule to incorporate exercise as a regular part of your life. To support you in your endeavours, keep a diary noting, time, opportunity to exercise, pros and cons for exercising, response, and solution if you did not take the opportunity to exercise in that instance. You will need to determine the best times for you to exercise and your diary may help your decisions.

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                  25. Nutrition

A healthy body responds better to life stresses, and good nutrition is fundamental to good health. Monitor your food intake for a week then analyze the record to see what changes need to be made. Gradually introduce a few changes at a time.

Positive Eating:

Reduce your fat intake – it is an accepted theory that saturated fats contribute to heart disease and stroke by raising the body’s cholesterol level.

Limit sugar intake – cravings for sugar can be better satisfied with fruit.

Avoid too much salt – recommended sodium intake is 3000 milligrams daily and 2000 milligrams for people with high blood pressure and on a low sodium diet.

You need in your diet, macronutrients (proteins, carbohydrates and fats) and micronutrients (vitamins and minerals) – the former in larger quantities and the latter in smaller amounts. Fibre is also needed – found mainly in plant products. You should eat mostly fruits and vegetables; least of high fat foods such as cake and chocolate; a moderate amount of foods such as bread, rice, potatoes and high protein foods such as meat and fish with less of the latter category than the former.

Find a healthy weight according to your height (Body Mass Index - BMI), and remember that weight fluctuates by 2-3 pounds in either direction.

Restrict your caffeine intake – coffee, tea, chocolate, colas and some medications are high in this stimulant. Caffeine can interfere with sleep and makes some people irritable as well as contributing to gastrointestinal distress.

Limit your alcohol consumption – alcohol is high in calories and low in nutrients. Weekly limit for men is 21 units and for women, 14 units.  

Supplement your diet with a multivitamin daily – this will not substitute for not eating well. You need to eat three meals and two or three snacks a day. Eat frequently and calmly – learn to savour your food. Drink plenty of water daily – roughly 6-8 glasses a day.

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                  26. Meditation

Meditation is achieved in attempting to focus your attention on one thing at a time. You need to meditate regularly to become adept at meditation.

Preparing to Meditate:

Choose a sitting position you find comfortable (e.g. sitting in a chair, cross-legged on the floor or on your knees with your feet under your bottom).

Sit, with your back relaxed but straight and let it arch.

Breathe through your nose with your mouth closed and place your tongue on the roof of your mouth.

Notice the sensations of contact with the chair or cushion and of where your body touches itself.

Notice your breathing. Take several deep breaths and feel your abdomen expand and contract with your breathing.

It is important you maintain a passive, unconcerned attitude about what you are doing during meditation.

You may wish to start by meditating for only five minutes at a time. Do not force yourself to sit longer than you want to – twenty to thirty minutes once or twice a day is sufficient relaxation.

Three basic meditations will be outlined. Choose your favourite and practise it regularly, at least once a day.

Mantra Meditation

Select your mantra, a word or syllable (e.g. ‘one’ or ‘OM’) – it may be a nonsense syllable you find pleasing. Prepare to meditate. Sit comfortably and take several deep breaths. Chant your mantra silently noticing any sensations in your body with the repetition of your mantra. You may wish to chant your mantra aloud. Notice any sensations in your body that are different from when you chant your mantra silently. Do you find chanting your mantra silently or aloud more relaxing? Be aware of your chanting and do not let it become mechanical.

Sitting Meditation

Prepare to meditate. Sit comfortably. Focus on the rise and fall of your breath. Concentrate on the sensations of breathing – inhaling, exhaling and your breath filling your lungs. When you are distracted from your breathing, gently focus on it again. Acknowledge any distracting thoughts by naming the thoughts (e.g. worry, planning). You need to practise regularly so that you can focus on your breathing more effortlessly and dismiss your thoughts more easily.

Breath-Counting Meditation

Prepare to meditate. Sit comfortably and take several deep breaths. Close your eyes or fix them on a spot in front of you. Your eyes may be focused or unfocused.

Take deep breaths and focus on:


The point at which you stop inhaling and start exhaling.


The pause between the exhale and inhale.

The point at which you start to inhale.

The inhale.

Continue with this noticing any sensations in your body as you inhale and exhale. As you exhale say ‘one’ and continue counting aloud to the fourth exhale when you say ‘four’. Then begin this count again. If thoughts intrude, gently return to counting your breathing. Do not worry if you lose count – simply start again. If you are distracted by any sensation in your body, focus on it until it recedes then return to counting your breathing.

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                  27. Creative Visualization

Stress can be reduced significantly by using your imagination. You are what you think you are (e.g. if your thoughts are sad you feel unhappy). Positive thinking and healing images are popularly used to treat physical symptoms (e.g. daily repeating the phrase ‘Every day in every way I am getting better and better’). Visualization can effectively treat stress-related illnesses such as headaches, chronic pain, muscles spasms and anxiety. Relief may be immediate or take several weeks of practise.

Preparing to Visualize:

Lie in a quiet place with your eyes gently closed and your clothes loosened.

Become aware of any tension in your muscles and relax them as much as possible.

Form images of scenes including all your senses: sight, hearing, smell, touch and taste.

Affirm your relaxation using positive, present tense statements. For example: ‘I am relaxing’ or ‘Tension is flowing out of my body’ – not ‘I am not relaxed’.

Visualize three times a day. At first you will find visualization easiest when lying in bed but eventually you will be able to visualize in other situations.

Learn to use your visualizations (e.g. daydreams or memories) to train your body to relax. Three types of visualization will be outlined.

Receptive Visualization

Prepare to visualize. Relax and empty your mind. Imagine a relaxing scene such as being on the beach. As you visualize the scene ask a question and wait for a response, for example: ‘Why am I so tense?’ ‘Because I have an important party to plan for tomorrow’.

Programmed Visualization.

Prepare to visualize. Create an image with sight, sound, smell, touch and taste, for a goal or healing you wish to attain. Daily visualize achieving the goal or healing until it is a reality.

Guided Visualization

Prepare to visualize. Imagine a scene in detail but leave out important elements. Then wait for your subconscious to fill in the missing details.

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                  28. Self-Hypnosis

Hypnosis is similar to sleep and very relaxing but you never totally lose consciousness during hypnosis. Hypnosis can be done with the eyes open or closed. During hypnosis your body will respond as if you are actually doing the activities you are imagining. Daydreaming or long distance driving are hypnotic states. Symptoms hypnosis can effectively treat include insomnia, minor anxiety, headaches, chronic pain and muscular tension.

Practise the basic induction once a day for a week, then add your specific hypnotic suggestions and practise until you no longer need it.

You first need to understand the power of suggestion:

With your eyes closed imagine carrying in your right hand a bag that gets heavier and heavier. After two minutes open your eyes and see if your posture has changed.

With your eyes closed imagine the wind is pushing you back. Notice if your body is swaying back in response to your imagination.

If you do not notice any movement with these exercises, hypnosis may not be for you.

You need to write and tape record a self-induction script – you could use the following:

Sit comfortably with your eyes gently focused on a point in front of you. Take deep relaxing breaths. As your eyes become tired continue to keep them open and take deep breaths. When your eyes have become very heavy, close them as you say your key word or phrase - this is the opposite of your problem (e.g. for anxiety ‘Relax now’). With practise this key word or phrase will be sufficient to quickly induce hypnosis.

Now relax the muscles in your body – feel your legs get heavier and heavier as the tension flows out of them. Feel your arms get heavier and heavier as they are pulled down by gravity and become deeply relaxed. Your face – forehead, cheeks then jaw begin to relax. Feel the tension go from your face as it becomes loose and relaxed and your lips begin to part.

Next, feel your neck and shoulders become more and more deeply relaxed. Take deep breaths and as you exhale each time feel your chest, stomach and back become calm and relaxed.  Feel yourself become more and more drowsy, peaceful and calm, drifting deeper and deeper and deeper into total relaxation.

Now it is time to go to your special place where you feel peaceful and safe. You reach your special place down a stairway or path, and with each step you count backward from ten to zero. With each step you feel more and more deeply relaxed.

Ten…nine…eight…seven…six…five…four…three…two…one…zero.(You may want to repeat this countdown a few times to deepen hypnosis).

See, feel, hear and smell your special place. You can feel calm and safe drifting deeper and deeper and deeper and feeling drowsy and peaceful in your special place – you drift down, down and down into total relaxation. (Spend some time feeling relaxed in your special place).

Now you know that you can…

(Leave a blank space on the tape here for the positive suggestion for change you wish to use [e.g. ‘I will be calm, in control and confident’]. Allow yourself time to repeat the suggestion at least three times).

Now, when you feel ready it is time to come back up to feeling alert and refreshed.  Count up: one…two…three…four… feel yourself become more and more alert …five…six…seven… more wide awake…eight…nine…start to open your eyes…and ten…you are totally wide awake, alert and refreshed. Wide awake, alert and refreshed.

Do not practise hypnotic induction in any situation where you need to be alert for your safety (e.g. in a car). After hypnosis, make sure you are completely wide awake before re-entering such situations.

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                  29. Autogenics

Autogenic Training is a hypnotic technique. It is a self-generated state of relaxation used in a hypnotic way for self-improvement. It is possible to create a state very much like a hypnotic trance just by thinking of heaviness and warmth in your extremities. Essentially, all you have to do is relax undisturbed, in a comfortable position and focus passively on verbal formulas that suggest warmth and heaviness in your limbs.

Verbal suggestions can be used to relax the body, calm the mind and resolve specific problems. The verbal formulas to normalize the body aim to reverse the ‘fight, flight, freeze or faint’ state that occurs when you experience physical or emotional stress.

There are six themes:

Relaxation of the voluntary muscles.

Relaxation of the blood vessels to allow greater blood flow.

Normalizing cardiac activity.

Regulating the respiratory system.

Relaxing and warming the abdominal region – the solar plexus.

Reducing blood flow to the head.

AT can effectively treat various disorders including muscle tension, hyperventilation, bronchial asthma, constipation, diarrhoea, ulcers, high blood pressure, headaches, general anxiety, irritability and fatigue.

AT is not recommended for children under five years old or people with severe mental or emotional problems. Before commencing AT you need to have a physical examination and discuss with your medical doctor the effects AT will be likely to have on you. You may need to be under medical supervision while in AT, if you are diabetic, hypoglycemic or have a heart condition. If you have high or low blood pressure you need to check with your medical doctor that AT is regularizing it. If you are anxious or feel any side effects after AT, you should continue AT only under the supervision of a professional AT instructor.

You will need to practise your autogenic formulas at least twice a day for twenty minutes. If this is too long, you can try shorter more frequent sessions each day. After one month of regular practise you should be able to relax quickly using all six themes.

Facilitating Relaxation for AT:

Ensure you are wearing loose clothing.

Choose a quiet, comfortably warm room where you will not be disturbed.

Turn the lights down low.

Sit comfortably with your head, back and extremities supported by an armchair or lie with your head supported, arms by your side but not touching your body and your legs about eight inches apart, with your toes pointing slightly outward.

Check that your position is tension free then close your eyes or focus softly on a point in front of you.

Breathe slowly, deeply and relax then begin repeating your autogenic formulas.

Make an audiotape of the verbal formulas and listen to it twice a day or memorize the formulas. You need to repeat each formula four times, saying it slowly then pause briefly. On the audiotape leave half a minute between each formula for silent repetition, as you passively concentrate on the part of the body it refers to. If you are focusing on memorizing one set at a time you can repeat the set for twenty minutes in a session or for mini sessions.

You may experience transitory unpleasant or pleasant experiences. These will pass as you continue to practise – just note them and return to your AT formulas.

To finish an AT session say to yourself ‘I will be refreshed and alert when I open my eyes’. Make sure you are wide awake when you resume regular activities.

Autogenic Verbal Formulas for Normalizing the Body:

Start with your dominant arm.

Set 1

My right arm is heavy

I am calm and relaxed

My mind is quiet

My left arm is heavy

I am calm and relaxed

My mind is quiet

Both my arms are heavy

I am calm and relaxed

My mind is quiet

My right leg is heavy

I am calm and relaxed

My mind is quiet

My left leg is heavy

I am calm and relaxed

My mind is quiet

Both my legs are heavy

I am calm and relaxed

My mind is quiet

My arms and legs are heavy

I am calm and relaxed

My mind is quiet

Set 2

My right arm is warm

I am calm and relaxed

My mind is quiet

My left arm is warm

I am calm and relaxed

My mind is quiet

Both my arms are warm

I am calm and relaxed

My mind is quiet

My right leg is warm

I am calm and relaxed

My mind is quiet

My left leg is warm

I am calm and relaxed

My mind is quiet

Both my legs are warm

I am calm and relaxed

My mind is quiet

My arms and legs are warm

I am calm and relaxed

My mind is quiet

Set 3

My right arm is heavy and warm

I am calm and relaxed

My mind is quiet

My left arm is heavy and warm

I am calm and relaxed

My mind is quiet

Both my arms are heavy and warm

I am calm and relaxed

My mind is quiet

My right leg is heavy and warm

I am calm and relaxed

My mind is quiet

My left leg is heavy and warm

I am calm and relaxed

My mind is quiet

Both my legs are heavy and warm

I am calm and relaxed

My mind is quiet

My arms and legs are heavy and warm

I am calm and relaxed

My mind is quiet

My heart is calm and regular

I am calm and relaxed

My mind is quiet

Set 4

My right arm is heavy and warm

I am calm and relaxed

My mind is quiet

My left arm is heavy and warm

I am calm and relaxed

My mind is quiet

Both my arms are heavy and warm

I am calm and relaxed

My mind is quiet

My right leg is heavy and warm

I am calm and relaxed

My mind is quiet

My left leg is heavy and warm

I am calm and relaxed

My mind is quiet

Both my legs are heavy and warm

I am calm and relaxed

My mind is quiet

My arms and legs are heavy and warm

I am calm and relaxed

My mind is quiet

My heart is calm and regular

I am calm and relaxed

My mind is quiet

It breathes me

I am calm and relaxed

My mind is quiet

Set 5

My right arm is heavy and warm

I am calm and relaxed

My mind is quiet

My left arm is heavy and warm

I am calm and relaxed

My mind is quiet

Both my arms are heavy and warm

I am calm and relaxed

My mind is quiet

My right leg is heavy and warm

I am calm and relaxed

My mind is quiet

My left leg is heavy and warm

I am calm and relaxed

My mind is quiet

Both my legs are heavy and warm

I am calm and relaxed

My mind is quiet

My arms and legs are heavy and warm

I am calm and relaxed

My mind is quiet

My heart is calm and regular

I am calm and relaxed

My mind is quiet

It breathes me

I am calm and relaxed

My mind is quiet

My solar plexus is warm

I am calm and relaxed

My mind is quiet

Set 6

My right arm is heavy and warm

I am calm and relaxed

My mind is quiet

My left arm is heavy and warm

I am calm and relaxed

My mind is quiet

Both my arms are heavy and warm

I am calm and relaxed

My mind is quiet

My right leg is heavy and warm

I am calm and relaxed

My mind is quiet

My left leg is heavy and warm

I am calm and relaxed

My mind is quiet

Both my legs are heavy and warm

I am calm and relaxed

My mind is quiet

My arms and legs are heavy and warm

I am calm and relaxed

My mind is quiet

My heart is calm and regular

I am calm and relaxed

My mind is quiet

It breathes me

I am calm and relaxed

My mind is quiet

My solar plexus is warm

I am calm and relaxed

My mind is quiet

My forehead is cool

I am calm and relaxed

My mind is quiet

When you have mastered the six basic autogenic themes you can use modifications for specific problems, for example: ‘My [tense or painful area] is warm and relaxed’. Never use the suggestion ‘My forehead feels warm’ because this increases the blood flow to the head and could result in pain. For headaches and blushing intersperse the formula ‘My forehead is cool’. To stop smoking you could repeat ‘Smoking is a disgusting habit, and I can do without it’. The formulas should be brief and realistic to the rational mind.

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                  30. Eye Movement Technique (EMT)

When you move your eyes rapidly back and forth while vividly imagining a stressful event, negative thoughts can be interrupted and you will gain relief from associated distress. EMT can help you control anxiety that is caused by recent or past events:

Focus on a stressful thought:

Rate your level of distress (0-10) while focusing on the stressful thought (0 is complete relaxation and 10 is extreme distress). For EMT to be most effective you need a stress level rating of 5 or 6 (a moderate level of stress). If your initial rating is higher than 6, try reducing your stress level to 5 or 6 by using relaxation techniques. If your initial rating is less than 5, try focusing on the stressful event until you reach a stress level of 5 or 6.

Once you have reached a stress level of 5 or 6, keep your head still and move your eyes back and forth twenty to twenty-five times between two corners of a room, between your hands placed on each knee or between two sides of a table. You should be able to stop focusing on the stressful event. If you are in a public place you can do EMT moving your eyes from side to side when your eyes are closed – it will look like you are in deep thought or resting.

As soon as you have finished rapid eye movement re-rate your distress. EMT significantly diminishes or blocks your ability to focus a thought or image. You should find you get a rating of 4 or less and additional sessions will reduce your level of distress further.

Repeat the above steps whenever the stressful thought recurs. EMT becomes more effective with repeated exposure. At first you may need to do EMT every ten minutes but soon you will get relief for longer. Eventually you should be able to use EMT to gain relief in the moment you have a distressful thought.

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                  31.  Mood Induction Procedure

Note the consequences (C) and activation event (A) for one of your emotional episodes on a DTR.

See Modifying Maladaptive Thinking.

Consider what thoughts enter your mind when you think about (A). Write down the dysfunctional belief (B) that enters your mind. Give it a credibility rating [0-100%].

Probe the next thought in the chain with the question ‘…and what follows from that?’ Write down this second (B) and credibility rating.

Repeat the above steps until you have at least two of your main evaluative beliefs. Rate the intensity of your emotional (C) at this moment [0-100%].

Dispute the first dysfunctional belief by writing a functional alternative belief in the column opposite and rate the credibility. Work down the alternatives column disputing each remaining dysfunctional belief and giving credibility ratings to each functional belief. Finally, re-rate the intensity of your emotional (C) [0-100%].

This procedure can give insight into your underlying beliefs but you will need to try In Vivo Graded Exposure to use your alternative beliefs at the moment in the situation when you experience emotional distress. Insight can be intellectual or emotional – the latter is insight during a particular emotional state. For example: Clients need to be in a depressed state to incorporate new thinking within it.

Try Rational Emotive Imagery (REI) after the Mood Induction Procedure to consolidate the insights.

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                  32. Rational Emotive Imagery (REI)

This technique will help you develop strategies to alter stressful emotions. Imagine vividly a situation that causes stress and unpleasant emotions. See, hear, taste, touch and smell the details of the event. Let yourself experience your uncomfortable emotions.

Push yourself to change these dysfunctional emotions (e.g. anxiety, depression, rage or guilt) to functional emotions (e.g. concern, sadness, annoyance or regret). Having altered your stressful emotions to more functional feelings, you can examine how you altered your original feelings – what were you thinking about yourself, others or the situation, to cause this change in your feelings?

You have changed your dysfunctional emotions to more appropriate feelings by altering your beliefs from maladaptive to adaptive thinking. Once you have identified the helpful belief you can substitute it anytime you want, to lead you away from stress.

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     33. Imago Graded Exposure        

Make a hierarchy of stressful events and start with the easiest event. Make a list of coping thoughts which reduce your anxiety for that event.

Relax – if necessary use Controlled Breathing and Relaxation Techniques.

Imagine you are in the stressful situation – see, hear, taste, touch and smell the situation. You could use a tape of anxiety provoking scenarios. Think about your anxiety provoking thoughts and feel your tension mounting. Do not use any safety behaviours as these maintain the problem by preventing you from discovering that your negative predictions do not occur (e.g. repeatedly checking the front door is locked as you fear otherwise you will be burgled).

Once you are anxious, start relaxing and using coping thoughts while imagining the anxiety provoking scene for about one minute. Afterwards rate your anxiety 0-10 (0 is no anxiety and 10 is extremely anxious). If your anxiety is 1 or 0 proceed to deep relaxation then move to the next situation in your hierarchy. If your anxiety is 2 or more, relax deeply then repeat the above scene.

Relax deeply before moving on to the next scene. Continue imagining and coping with the scenes until you can cope with the most difficult scene in your hierarchy. Practise daily – your first session may be 15-20 minutes but later you may want to extend this to 30 minutes.

You can also use this technique to cope with anger provoking situations – make an anger hierarchy and list coping thoughts to reduce your anger. Imagine the anger provoking scene and use coping thoughts. Rate your anger and proceed as instructed above. Imago Graded Exposure can be used to combat fears that cannot be re-created in real life (e.g. contracting AIDS).

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     34. In Vivo Graded Exposure

To overcome your fear you need to face it at your own pace in safe situations. Identify and write down an accurate description of your fear. Deal with one fear at a time. Drop any safety behaviours as these maintain your fear by hindering you from finding that the predicted catastrophe does not happen (e.g. resting in a chair when your heart is racing because you fear having a heart attack).

Graded exposure will show you that your fears are not really alarming and build your confidence. You are trying to learn to master your anxiety/anger/fear rather than avoiding it.

There are three stages:

Setting targets – your descriptions of fears such as objects and situations that cause avoidance, anxiety or anger need to be arranged in order of difficulty (a hierarchy) with the easiest first. These are your targets.

Grading tasks – choose a target and plan a series of steps which become progressively difficult so that you can build on your successes. Each step should be altered in one aspect at a time to increase the difficulty and allow you to build your confidence (e.g. if your target is to go shopping at a large supermarket, you could start by shopping for one item at the local shop with the correct money; then several items with the correct money; next, shop at the local shop for several items with a credit card and proceed to shopping at a large supermarket in such graded steps).  

Practising – repeat each step until your anxiety is no longer there, then proceed to the next task and reward yourself for your achievements.

Keep a diary to remind you of your progress. Note the date and task and give a rating for your anxiety 1-10 (1 is no distress and 10 is most distress) before, during and after exposure. Write down any other related details.

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                  35. Persistence

Persistence is a quality which is essential for success and achievement in life. If you want something you need to persist (continue trying) until you obtain what you desire. Change requires goal-orientated, persistent and forceful action which is 24 hours a day, 7 days a week. You need to strive to solve your problems.

‘Genius is 1% inspiration and 99% perspiration’ [Thomas Edison]

You feel the way you think and remain upset in the present because you continually strengthen your irrational ideas. To overcome your emotional problems you must persist working hard and practise implementing rational ideas. ‘Trying’ will not commit you to desired change – ‘doing’ and sustained action will lead to obtaining your goal. You have will power if you are determined to change and to work to realize the desired change, and to do actual work because of your determination.  

People fail to persist due to:

Low Frustration Tolerance (LFT) – this is when you find the work associated with a desired change to be too difficult. It is necessary to put up with short-term discomfort to attain long-term goals.

You may think the answer to your problem lies in understanding the past. However, you need to realize that current problems are maintained by current ideas and behaviour.

It may be you think that you cannot persist because you feel worthless. Learn self-acceptance and do not judge yourself, only your actions, in order to maintain persistence to overcome your problems.

Changes in your behaviour may feel unnatural. Tolerate these uncomfortable feelings and view them as apart of the change process.

By holding others responsible for your desired change in behaviour and demanding their support, you accept less personal responsibility and feel you cannot achieve your goal alone.

Perhaps you feel that you cannot change because you were born that way. Avoid being pessimistic and employ increased and sustained effort to overcome your problem.

Maybe you feel that if you do not succeed in your goal, your efforts will have been wasted. You must realize that whatever the outcome of your hard work, striving for an uncertain future is more rewarding. If you feel like giving up when you see no immediate progress – be patient for the desired change.

You may feel you have committed yourself to a failed investment. Consider what you have gained from this commitment, reasons for avoiding change and how you can now obtain a more interesting life. It could be you feel that you are too old to change. Challenge this idea by seeing it as a hypothesis to be tested and not a fact. Test the idea and see what improvements you can make in your life.

Perhaps you are leaping from task to task. It is necessary to complete a task before moving on to the next task. Success at a task can be viewed as experiencing the problem less frequently, less intensely and for shorter periods of time. Keep an eye on completed tasks so they do not become troublesome again.

Hidden agendas are the real reasons people enter coaching/therapy rather than the reasons they state. You need to realize that you will not be criticized if you reveal what is really going on.

Maybe you feel that having succeeded at a goal you will maintain progress without further effort. You have to daily practise your new thoughts and behaviours so that they become second nature. You may not feel any different for a long time despite your efforts – be patient and persist with the change process and eventually your mood will improve.

It could be that you are maintaining your problem because you feel without it you would have other problems which would be worse than your current problem. Just ‘seeing’ a problem will not solve it. You need insight and forceful, persistent action to achieve enduring change.  Counter lack of repetition – repetition ensures that information ‘sinks in’. Be persistent, sustain effort and tolerate the discomfort of persevering to attain your desired goal. If you give up the struggle of ‘sticking to it’ you may face worse consequences than if you had persisted.  

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             36. Criticism

Criticism can be constructive or destructive – the former targets behaviour and the latter criticizes you as a person. It is your thoughts about a situation or criticism that determine how you feel and not the situation itself. You may feel you need approval and cannot cope without it. Try to stand up to criticism by accepting yourself. It is not you but your actions and traits that are the problem.

See Coping with the Need for Approval.

Be aware that needs are what you feel you must have. Desires are what you would like but can cope without. Rejection may feel like extreme criticism. You need to realize that you can be rejected and not reject yourself. It is when you reject yourself that you get into emotional trouble.

When you are criticized you may become defensive and resort to rationalization. Try to find plausible reasons that oppose the criticism. You need to try and think rationally and see if there is any truth in the criticism. In this way you will be open to criticism without necessarily agreeing with it and avoid becoming defensive.

‘No one can make you feel inferior without your consent’ [Eleanor Roosevelt]

If you get angry and lash out about criticism which appears to attack your self-esteem, keep in mind that it is only part and not you as a whole that is being criticized. It may be that you do not deserve the criticism but sulking because you are hurt will not solve the problem. If someone is constantly criticizing you, ask the complainer to be specific about the criticism. Ask yourself whether the criticism is true or false. If it is true consider remedial action, otherwise let the complainer be wrong and get on with something enjoyable.  

Shame occurs from social disapproval you agree with whether actual or imagined. Perhaps you fear criticism because your defects will be exposed to others who as a result are likely to disapprove of you. Challenge your shame prone thinking and find rational alternatives. Accept yourself irrespective of how others view you.

See Shame.

You are your worst critic. You could try writing down self-attacking statements and challenge each one in a self-appreciative way. Only by accepting yourself can you put an end to your inner critic.

To cope with performance evaluation you need to self-evaluate your performance and try to improve if necessary. You may need to ask for the criticism to be made more specific or you have to ignore it and not let it disturb you. When giving criticism bear in mind that it will cause emotional distress to the person being criticized, but they are ultimately responsible for the distress. However, you should express criticism constructively.

Giving or receiving criticism can cause stress:

Prepare yourself for criticism by being aware of your areas of weakness and choose to live with them or take steps to improve them. Accept that occasionally your behaviour may be criticized and respond appropriately, with confidence.  

Do not react immediately to criticism – relax your body and listen attentively. If the criticism is valid, acknowledge it, apologize if appropriate and show you are willing to alter so that it does not recur. If there are circumstances which may be considered, explain them after accepting the criticism and not as an excuse. If you disagree with the criticism, show you have listened then say you disagree and why. Asking for more information if necessary may clarify your communication style or cause the person criticizing you, to back down. If you agree with part of what has been said, calmly agree with that element, but question the part with which you disagree.

When giving constructive criticism:

Identify precisely the behaviour you want to criticize.

Select the time and place.

Introduce the subject and describe without evaluating or judging, the behaviour you want altered.

Request a specific change.

Make sure you get a response to what you have said.

Point out positive and negative consequences of whether or not the desired action is taken.

Facilitate discussion about the issue.

End the conversation with a summary.

Constructive feedback (positive and negative feedback based on observation, not interpretation) better describes ‘constructive criticism’. Praise and criticism however, are both personal judgments.

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                  37. Countering Self-Criticism

When you have the sense that your negative beliefs have been confirmed by experience the result is self-criticism. Make a note of the words you use to describe yourself when you are being self-critical. You will need to watch out for these words. You frequently learn self-critical thinking early in life. It becomes a habit and is not necessarily based on truth. Self-criticism makes you feel bad, is unfair, blocks learning, ignores the realities and demoralizes you when you are having difficulties.

To counter negative opinions you may hold as being true: list the negative opinions then tear up the list and bury, burn safely, or flush the pieces down the toilet.

To combat self-critical thoughts make a record of the thoughts going through your mind when you feel bad and note:  

Date and time.

The situation.

Your feelings and bodily sensations, rating the intensity 0-100%

Your self-critical thoughts, rating credibility 0-100%

Self-defeating behaviour – what you do as a result of your self-critical thoughts.

Question your self-critical thoughts, exploring both supporting and contradictory evidence for them. Are you confusing a thought with a fact? Look for more realistic and helpful alternative perspectives. What evidence is there to support them? Do you assume your perspective is the only one possible? What is the effect of the way you think about yourself? Are your thoughts helpful or a hindrance? What perspective might be more beneficial for you?

Are there biases in your thinking? For example: jumping to conclusions; using double standards; all-or-nothing thinking; expressing strong disapproval of your whole self, based on a single event; focusing on your weaknesses and disregarding your strengths; blaming yourself needlessly; setting yourself very high standards.

See Modifying Maladaptive Thinking.

Consider what you can do to get a new perspective and practise acting in a less self-defeating way. In your record note your alternative perspectives, rating belief/credibility 0-100%. Your belief will increase as you experiment with viewing yourself more positively.

See Improving Your Self-Image and Combating Self-Harm.

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       38. Assertiveness Training

The aim of assertive behaviour is to stand up for your legitimate rights and face others without putting yourself or them down. Assertiveness Training teaches you to increase the number and variety of situations in which you are assertive.

There are three types of interpersonal bevhaviour:

Aggressive – you may be forceful in expressing your opinions, feelings and wants.

Passive – your opinions, feelings and wants may be withheld completely or partly.

Assertive – opinions, feelings and wants are stated with respect for the rights of others.

Make sure you are aware of your fundamental rights which include:

Asking what you want.

Saying ‘No’ without guilt.

Not being perfect.

Being ignorant about something.

Being responsible for your actions.

Having your own perspective and emotions.

Being indecisive.

Choosing whether or not to deal with others’ difficulties.

Expecting privacy, independence and success.

Valuing yourself and others as equals.

There are five steps to being assertive:

What do you want?

What is fair?

Be clear in asking for it.

Contemplate and be ready for the risks.

Stay calm.

Rehearse – practise your arguments in advance and repeat yourself to get the message across. Be prepared to negotiate. Think about situations in which you are not assertive and how you could change this and be assertive. Write out a detailed description of problem scenes – note when and where the problem occurs; who is involved; what your difficulties are; how you handle it; your fear of what will happen if you are assertive; your goal.

To deal with a problem situation:

Consider your rights and wants.

Unless spontaneous action is required, arrange a mutually convenient time to discuss your problem with the other person.

Define the problem as specifically as possible.

Describe your feelings using ‘I’ messages, to give the other person an understanding of how important the issue is to you.

Make your request in one or two simple but firm sentences.

Give positive reinforcement to get what you want, for example, ‘We’ll be able to spend more time together’. If this will be ineffective try negative reinforcement, describing the alternative way you will look after yourself if your wishes are not met.  

You need to arrive at a workable compromise. Agree to review this after a specified length of time and if you are not both satisfied you can re-negotiate.

Avoid being manipulated – techniques include:

‘Broken Record’ – where you choose a concise assertive statement to say over and over to get your message across.

Delay responding to a challenging statement until you are more prepared.

Inviting criticism may reveal what is troubling the other person.

When someone puts you down, acknowledge something you agree with in their criticism and ignore the rest.  

You can change the focus, from discussing the topic to analyzing the interaction between the two of you.

In instances where you lack time you could use the short form assertiveness technique. Consider:

Your thoughts – state the facts as: ‘I think…’

Your feelings – express as ‘I’ statements: ‘I feel…’

Your wants – specify behaviour change as: ‘I want…’

Stating your preferences with respect for the opinions of others is assertive behaviour.

You need to develop assertive body language. Practise the following basic rules in front of a mirror so that you learn how to apply them to problem situations:

Maintain eye contact and an erect body posture.

Speak clearly and firmly.

Emphasize what you are saying with gestures and facial expressions.

Crossed arms indicate defensiveness and a tilted head may be a sign of boredom. According to the ‘Pinocchio Syndrome’ [Dr Alan Hirsch] – blood rushes to the nose when people lie. This makes the nose itchy. As a result people who are lying tend to scratch their nose or touch it more often.

Learn to listen more assertively:

Make sure you are both ready to listen.

Listen giving the other person your full attention and ask them to clarify if necessary.

Let the other person know you have heard what they have expressed to you.

Practise being more assertive in problem situations and consider how it makes you feel. Role-playing is a good way to improve your assertiveness in a safe environment before trying it out in real life situations. You can role play (psychodrama) with a friend or take on both sides yourself. Observe work colleagues and friends who are assertive in their behaviour and view them as role models.

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                  39. Building Confidence I

When confident you may:

Believe it is possible to deal with things others find difficult.

Feel balanced and ready for action.

Approach goals with a sense of purpose.

Know you can tackle whatever life brings.

Be sure that all will end well.

Confidence embraces:

Having a sense of direction.

Living according to your values.

Being motivated, emotionally stable and optimistic.

Self-acceptance – accepting you as a fallible human being and not expecting perfection. You know your strengths and how others see you.

Flexibility – you adapt to your circumstances and do not make demands.

Maintaining good health with a nutritious diet, regular exercise, adequate sleep, and effectively managing your level of stress.

Taking calculated risks.

Having a sense of purpose in life.

Your confidence will grow if you focus on your strengths rather than your weaknesses, and eliminate negative thoughts. List what you are good at and think how you can enhance these talents. Request feedback from significant others. Build positive feedback into your goals and let the rest go.

Consider how you relate to others in your life:

Write down how you currently relate to each significant person in your life.

Write in detail how you would like each relationship to be in two years’ time.

Act ‘As if’ the desired change has already taken place.

List in hierarchy the things that sap your confidence (e.g. long hours, untidy house). What would be the benefits of resolving the thing that drains your energy the most? What areas of your life are affected by confidence? Rate each area 1-10 (10 is the level of confidence you desire). Is there any imbalance you need to change?

To get the result you want, try to:

Decide what you want.

Plan the action required to obtain your desire.

Take appropriate action.

Consider the results you are getting.

Modify your action according to the results.

Repeat steps 2-5 until you get what you want.

Choose as a role model, someone who does things the way you want to; model their behaviour including how they are doing it and their feelings and thoughts. In social gatherings you will appear more appealing if you give others your full attention instead of being anxious about the impression you make on them. A sense of achievement will motivate you to achieve even more. When offered a promotion ask yourself if that is what you really want. How did the previous person holding that position fare? What are the pros and cons of accepting the new role and of remaining in your current position?  

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                  40. Building Confidence II

Be clear about what you want, why you want it and how you can get it. What are your values/principles? Identify your top values by asking yourself:

What is most important to you?

After that what is the next most important?

Then what is the third most important?

For each of the three values ask you: If I have this what does it give me? Continue questioning each answer with: And what will that give me? – until you reach a fundamental emotion or feeling (e.g. financial security, love). You are now in a position to take action to get more of the positive emotions in your life and less of the negative emotions. In this way your values (the emotional states you want to feel) will be satisfied.  

Each night make a ‘To do’ list for the next day. In the morning decide how you will fit these activities into your day. Start with the most important and leave out the less important tasks if there is too much to include. At the end of the day, review what happened. Did you complete your ‘To do’ list? Perhaps you tend to give yourself too much to do. How can you get the balance right?

If you have bad memories, try to separate the memory from the emotion involved. Imagine the event. How did you feel? Rate the intensity 1-10 (1 is weak and 10 is strong). See the event as faded, with no colour or emotion. What can you learn from this memory for future use? What action can you take as a result of the knowledge you have now?

Monitor your mood early in the morning, mid-day, mid-afternoon, early evening and just before going to bed. Describe your feelings at these times and identify what triggers changes in your mood. From this record you may see what changes you need to make to your day to prevent a negative mood.

Listen to your intuition and just go with what feels right. In this way you can connect with what you really want in life. To be confident, you need to act according to your feelings (congruence) and in line with your values.

Express your passions – bottling up emotion can result in an outburst and is detrimental to your health. Passion is empowering and immensely motivating. It will enable you to achieve ever more and realize your dreams. Pursue your dreams of how you want to be, rather than the things you want to possess in life. If you expect the best to happen, it usually will.

You can confront fear by imagining your fear and getting a strong picture in your mind. Frame the picture, and shrink it to a tiny black dot in the furthest corner of the room. You will notice that your fear is now diminished. Change fear into confidence by asking: What do I fear? How did it start? What action can I take to overcome my fear?  

Make a list of all your successes and when your confidence wanes refer to this list. You may say you lack the time, energy or money to achieve your dream now:

Assume you have the time, energy and money.

Write down your dream in positive terms.

Consider if you can do it now – if not go to Step 4.

Break your target into several smaller more manageable tasks.

In this way compile a list of small tasks to do today or by a specified date.

The 80/20 principle suggests that 80% of your results come from 20% of your effort. Stop struggling for 100% perfection and accept an 80% result. Now give 20% of your time to concentrate on getting this result.

Simplicity is more productive (Acronym KISS – keep it so simple).

There will always be times when your confidence dives. In such cases bring to mind the successes you have had so far. Envision a happy ending and plan some treats for yourself. Be flexible and adapt to your circumstances.  

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                  41. Building Confidence III

Hiding in your comfort zone is lack of confidence. Just as your body needs to be stretched to stay in top form, so does your mind. Create a place where you can go to rest and recuperate:

Find a quiet corner of your house where you will be undisturbed and comfortable for half an hour. Spend five minutes controlling your breathing and relaxing.

See Controlled Breathing and Relaxation Techniques.

Next, use visualization to relax, for twenty minutes.

See Creative Visualization.

End the session by gradually returning to your normal waking state. Whenever you need to restore your normal balance, go to this place and relax your mind, body and spirit.

When setting yourself goals, make sure that it is you who wants your goal and that it is not being imposed on you by someone else. Positively focusing on your goal makes it more likely that you will get what you desire.

Look after your health – feeling good increases your confidence. Stress can result in low mood and can be detrimental to your health.

See Program 22: Overcoming Stress and Program 23: Overcoming Stress At Work.

To maintain optimum health you need a nutritious diet of good quality food and water, adequate rest, a healthy environment, varied and challenging work, leisure activities and a good support network.

See Nutrition, Exercise, Managing Your Time and Sleep Management.

Your confidence will increase if you are honest to yourself and others, treat people with respect, keep your word, do not judge others, admit to your mistakes, let people know what is important to you, and live according to your values.

First impressions last, so make sure you are appropriately well dressed for an initial meeting. Get a wardrobe of clothes that you feel confident in, and is versatile. Dress smartly in well-fitting outfits and follow the dress code for the occasion.  

Those close to you may not be too happy about the new confident you. Reassure them that you will still be there for them. Your confidence may suffer under pressure. It is a good idea to keep handy, a list of people you know who may be of help at such times. Always help others in need if you can, as this tends to come back to you when you most need it. Take each day as it comes. Do not take on unnecessary responsibilities. Keep in mind the bigger picture and all your successes so far. Reward yourself daily with small luxuries, and build a good support network.

To be fully confident, your work needs to be in line with your values in life. Ask yourself:

What do you enjoy about working?

What do you do well at in your work?

What aspects of your work are essential for your job satisfaction?

What do you really want to do?

If you are being bullied at work, do not let them have control over you. Realize that it is the bully who is inadequate and NOT YOU. Steps you can take are:

Keep a diary of incidents.

Discuss the situation with colleagues.

Confront the bully.

Make a formal complaint with advice from HR (Human Resources).

Effective feedback is clear, specific, focuses on the desired action, and sandwiches any negative points between positive aspects. Ask your boss and colleagues what they expect from you that show to them, you are doing a good job. Write these down then compile an action plan to help you achieve some of the really important objectives you feel you can realistically achieve. Next, let your boss and colleagues know what they can expect from you.

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                  42. Building Confidence IV

Make a list of the top ten things you most want in a romantic relationship. Trust, good communication and acceptance (warts and all) are likely to be at the top. Being funny, caring and having the likelihood of an irresistible future, may follow closely.

Confidence is when you are empowered to take action despite your fears. In a good relationship both your needs and your partner’s will be understood by each of you and fully met. It is when there is difficulty communicating these needs, that the relationship is threatened. At such times, confiding in a close friend can help you see the situation more clearly.

Consider what makes you feel loved by your partner. Visualize a time when you felt strong feelings of being loved by someone. Re-live the intense emotions. Next, list what is essential for your partner to do so that you feel loved (e.g. take you to a restaurant, buy you a present, look, speak or touch you in a certain way). Finally, share the list with your partner and get them to also make such a list.

When you are in an abusive relationship or your partner has been unfaithful, you need to decide whether or not to restore and improve the relationship or leave your partner. Changes in people, circumstances and relationships are inevitable. You need to accept and grow with these changes and work together for an irresistible future.

If your inner voice is critical, try to reply with positive phrases to change your inner voice to a compassionate one. Be proud of your name and see yourself as a person who is a worthwhile friend. Choose friends who are good role models for you and get rid of those who drain your energy.

Write down a confident thought daily. What wisdom about being confident would you give to others? Consider the tensions in your life (e.g. family versus work). Make changes which are right rather than easy. There may be a particular point which keeps coming up but you never get around to dealing with it. What are the benefits of resolving this point? How would your confidence increase as a result? By resolving this issue you will be freed and energized to tackle other problems in your life.  

Stop limiting yourself. What do you really want to be? Take the first steps toward this today. Failures and rejection are all obstacles on the journey toward your goals. So when you face these hurdles bring to mind your values, aims and talents. Success requires persistence and stretching yourself.

See Persistence.

Confident people have a balance between effectively dealing with time alone and time with others. Daily spend ten minutes alone, content in your own company. This will prevent you from being overwhelmed by the demands of other people and restore a balance. Confident people try not to waste even a minute of their life.

Try making a habit of regularly (if not daily) writing spontaneously on to an A4 blank page. Usually, something useful comes from this writing. The activity can clear your mind and calm the logical part of your brain, allowing you to be creative.

Keep a Positive Data Log/diary/journal. Write five positive qualities you think you have. Rate how strongly you believe each statement 0-100%. Can you remember specific examples of these positive qualities?

Use Positive Comparison – making one’s own situation appear better by comparing it with that of others who are worse off.

Write ten strong positive statements that strengthen your preferred new way of seeing the world – affirmations (e.g. ‘I am in control of my life’ ‘I am surrounded by love’ ‘I am the best I can be and that is sufficient’). Repeat out loud each affirmation ten to twenty times daily. Affirmations can powerfully influence your experience of the world.  

Write down in as much detail as possible your biggest dream. Read it every day. Daily take one action that brings you closer to it and stop one negative action that hinders your success.

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            43. You and Your Family

You may want reconciliation and improved relationships with your family, or compromise. Alternatively, you may choose to distance yourself from your family. Record your feelings and triggers for them, when you are with your family. Establish ground rules for dealing with your family. List what you want or need from your family. How can you ensure you get what you need? In order to understand the difficulties you face, visualize an event where you state what you need. What feelings and associated thoughts do you have?

To be assertive it is necessary to think about what you need or want - what is in accordance with reason and just? Make a reasonable proposal which is often a compromise. What would be the results of your proposal not being adequately thought about? If assertiveness is a problem for you consider doing an assertiveness training course.

See Assertiveness Training.

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             44. Removing the Obstacles to Intimacy

If you have been abused you may feel confused in intimate relationships. Record and examine closely the things that prevent you from achieving intimacy with someone. Note your thoughts and reactions when you distance yourself from a friend or end a relationship, and make an analysis (e.g. are you overgeneralizing?)

Social inadequacy can be an obstacle to intimacy. Apply your assertiveness skills to your social life and work life. Observe how socially skilled people handle situations, in particular difficult ones. Rehearse your social behaviours so that you are comfortable with them.

See Assertiveness Training and Social Skills Training.

Try to grasp your anxious thoughts, examine them closely and if required, challenge them. What are your anxious thoughts? Is your outlook biased – are there misjudgments? Consider the evidence to support and discount your thoughts.

See Modifying Maladaptive Thinking.

It is possible to become overly intimate and make ourselves vulnerable to exploitation. Trust can be given in a series of stages and you can fluctuate as to how much you trust someone. Communication is necessary for all relationships. Record the feelings which threaten your relationship (e.g. jealousy) and grasp the automatic thoughts. Analyze them and find alternative ways of dealing with the situation.

See Communication Training and Negotiation Training.


Co-dependency is an addiction to unhealthy relationships. For example, an alcoholic and co-alcoholic fit together in a destructive manner ingrained by their dysfunctional upbringing. The co-dependent complies with, tries to control, and merges with another person, losing their identity and boundaries thus, is left vulnerable to abuse and violence. Denial and low self-esteem are prevalent with co-dependency.

In co-dependency destructive, painful patterns from childhood are repeated in the hope of altering some aspect of the situation. It is necessary to come to terms with any needs that were not met in infancy and take adult responsibility for your life now.

Re-parent the child in you using the ‘Empty Chair’ technique. Imagine your ‘Inner Child’ is sitting in front of you and talk to them focusing on what you as an adult would say to a child who is hurt and upset; or you could write a letter to the same effect.  

Addicted to love:

If you are addicted to love, the first step to recovery is to accept that you love too much. It is likely that your childhood needs were not met due to a dysfunctional home. You may now assume the role of caretaker/fixer in your relationships to vicariously compensate for your lack of nurturing in childhood – you need to be needed. Perhaps you continually try to recreate the maladaptive patterns of childhood with your partner, in an attempt to finally change the situation. You feel the need to control your partner and have an extreme fear of abandonment. Your low self-esteem means that you often bend over backward for your partner. You must realize that you deserve to be loved and need not take the entire responsibility in a relationship. You may also have other addictions (e.g. alcohol, drugs, food), or suffer from episodes of depression. It could be that you find a healthy relationship to be ‘boring’. You have to start living in reality.

The recovery process requires you to:

Accept you have a problem.

Make your own recovery the first priority.

Find an appropriate support group to share your experiences, and build a good social network.

Develop your spirituality.

Stop managing and controlling others – respect that others can solve their own problems.

Take adult responsibility for your life and realize that you have freedom of choice in matters.

Work on personal development and usually, put yourself first.

Face up to and attempt to resolve your problems.

See Problem-Solving.

It is necessary that you distance yourself from your lover/target and spend some time away if possible, to get a clearer perspective of your circumstances.

To counter obsession it is crucial that you shift the focus from your lover to yourself. What is in your best interests?

Do you pursue others to complete aspects of yourself that are missing? How could you develop the traits you want, so that you can be whole?

Keeping a log of your obsessive thoughts for a few weeks will help you disconnect from your obsession. Analyzing your obsessive thinking will impact on your feelings and behaviour.

See Modifying Maladaptive Thinking.

You may be able to positively change your behaviour thus, eliciting altered responses from your partner, resulting in a better, healthier relationship. Otherwise, you need to accept that there is no future for the relationship and move on in life.

Initially, when the challenge of manipulating an impossible relationship ends, women/men who love too much may find sex in a healthy relationship less satisfying. Talk matters through with your partner and be very, very honest – hopefully the situation will resolve itself.

Apply addiction strategies to deal with your obsession.

See Program 4: Overcoming Addiction

Stay or Leave:

If you are fighting about money in a relationship it is essential that you figure out exactly what you are really fighting about, for example, how much you hurt in the relationship, the need to maintain your independence, or the fear of abandonment.

Out-dated beliefs and feelings may be controlling you, leading to hoarding; self-deprivation; sabotaging your success; reckless spending/debting; compulsive gambling; enabling a money reckless spouse; and guilt about earning more than your husband.

See Modifying Maladaptive Thinking.

In a good relationship the needs of both partners are met; there is mutual respect, and a relatively equal balance of power.

Before deciding whether to stay or leave a relationship, make two lists – one of reasons to stay, and the other of why you want to leave.

If you choose to stay in a currently abusive relationship it is crucial that you stand up for your basic right to a genuine, loving partnership. You will both have to do a lot of work to establish a healthy relationship.

When your partner has been financially irresponsible they need to make you an informed partner in all further expenditure beyond an agreed amount, and you must ensure that you are not accountable for any debts your partner may incur in future.

For a healthy relationship you need to set limits on your partner’s behaviour. Clearly define what you want and what you will no longer tolerate. Defining boundaries will enable you to maintain a sense of healthy individuality, and ensure you do not exhaust yourself by giving too much to others.

Your partner has to take personal responsibility and agree to change, taking immediate action toward sustained, positive behavioural change. Keep in mind that you can only change yourself, but by doing so, your partner is likely to alter their behaviour in response.

See Making Your Love Last and Program 13: Overcoming Destructive Relationships.

If you choose to leave an abusive relationship ensure you put your safety first when discussing your decision.

It can help to safely burn or bury items of emotional charge that remind you of your ex-lover, and formally say ‘Goodbye’ to the relationship.

An effective way to keep hold of the happy memories of a past relationship is to write on pieces of paper, over several weeks, the good and bad aspects of the old relationship. Separate out the positive statements from the negative ones, then dispose of the latter by burying or burning safely.

Prepare a eulogy [e.g. ‘I hereby lay to rest the relationship of (your name) and (their name)’. Write about the good and bad aspects of your time together and how you will cope in the future. End with ‘Rest in peace’]. Read out loud with a friend or on your own.

You may wish to write a eulogy to release any fultile fantasies you hold about your parents fulfilling their roles and meeting your needs.

See Program 15: Overcoming Grief And Bereavement.

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             45. Sexual Problems

Your sexual relationship will be affected by how good your relationship is with your sexual partner, how you feel about yourself and your body, your mental state and your understanding of sex.

See Improving Your Self-Image and Combating Self-Harm.

Sexually abused children are often ashamed of asking about sex. Thus, they have a poor knowledge of sex.

Think about your needs and work out ground rules for your sexual relationship that will help you meet them. Share and discuss this with your partner. Study your sex-related stresses by noting the feelings and grasping the thoughts then analyzing them and finding alternative ways of dealing with the situation.  

Learn to develop more positive feelings about your body. Visualize a child who has never experienced sexual abuse. How does it come to like its body? These are the things that will enable you to improve your relationship with your body (e.g. dressing up and accepting compliments). Note how you could start to like your body (e.g. treating yourself to perfume or lotions). Try not to compare yourself to just the best looking people. This will only be discouraging.

Threat tends to trigger dissociation/detaching from reality. Try to grasp, examine closely and challenge your fears. You may be able to get rid of some of them and dissociate less. It is necessary to attempt to maintain a good mood since this affects your sex drive. Challenge myths about sex.

If you think physical damage is the cause of painful sex you should have a physical examination. Another reason may be muscular tension. The woman who experiences pain can use lubrication (e.g. KY jelly) and insert one finger then two and even three into her vagina and masturbate if she wishes. Alternatively, glass trainers can be used and gradually increased in size – ask your doctor for more information.

[Sensate Focus]: As a couple, partners can avoid penetration and concentrate on pleasuring each other without genital contact. Next, they can begin to touch each other sexually but avoid penetration. Finally, when both are ready and relaxed they can attempt gentle and gradual penetrative intercourse. The woman needs to gradually lower herself onto her partner’s penis and proceed to ejaculation/orgasm. In this way she can control the speed and depth of penetration.

For male sexual dysfunction the ‘Stop-Start’ and ‘Squeeze’ methods may help: The man can masturbate or his partner can stroke his penis to erection and stop just before ejaculation (and squeeze penis if required). Repeat this three times before proceeding to ejaculation.

For sexual problems such as: erectile dysfunction (male impotence), premature/retarded ejaculation, lack of ejaculation, inability to achieve orgasm, vaginitis (dry vagina), dyspareunia (painful sexual intercourse), vaginismus (involuntary contraction of the muscles at the entrance to the vagina preventing penetration), loss of/differences in sexual libido and comfortable sexual positions for those who have had hip replacements – see a medical doctor for further information and possible remedy.

You need to treat sex as being of most importance and make known your own needs with regard to sex.

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             46. Dealing with Relationships

Interpersonal relationships may have caused your problems and may be preventing you from recovering – in any event interpersonal relationships will be affected by your problem. You need to understand your interpersonal relationships and be able to deal with them effectively.

Draw interpersonal maps for:

How your interpersonal relationships are at present.

How your interpersonal relationships might be now if you did not have your problem.

How your interpersonal relationships will be in ten years’ time if you do not overcome your problem.

How you would ideally like your interpersonal relationships to be.

These will summarize all your relationships and allow you to recognize any changes you may desire. List all your important relationships and put your name in the middle of the map in a circle. Place each person’s name in circles on the map, around you in the middle – the closer the relationship to you, the closer the circle to you. Join these circles to you in the middle with an arrow outward if it is you mainly giving; an arrow inward if you are mainly receiving; a two-way arrow if giving and receiving is balanced; a question mark if you are unsure.

Examine these maps noting any differences and set yourself goals to make any desired changes to your relationships.

For each relationship ask yourself:

Who initiates and terminates contact?

Are you happy with how often you see this person?

Who decides what to do or what to talk about?

Is there a balance between giving and receiving?

Do you want to alter the relationship in any way?

Consider questions such as: Who could I confide in and get advice from? Who would be there for me if I fell ill? Who would lend me money at very short notice? Next time you have contact with each person, examine the relationship – participate and observe. Were your predictions correct? If not, what was different? When you have a complete picture of your relationships, think about how you maintain them and in what ways you want to change your relationships.

Two important reasons for making changes are:

A balanced and supportive social network is necessary for your well-being.

By altering your relationships but avoiding being controlling, you may increase your sense of control.

Start by making small changes and monitoring progress. You could also try discussing what you have learned about the relationship with the individual.

Make a list of your ten most important needs then put these in three lists:

Needs you must have for the relationship to continue.

Needs you would like, but are willing to settle for an alternative.

Needs you could let go of.

Swap notes and discuss with your partner what you have learned.

How much do the following lifestyle factors affect your argument rate?




Time apart

Special occasions

Lack of space



Use a rating from 0-5 (where 0 is does not affect you at all and 5 is affects you a lot).

How could you resolve the problem?


Draw a horizontal line across a page marking the start with the year you first met your partner and the end with the present year. Mark in the line any key events in your relationship (e.g. moving in together, wedding day). Next, mark in any life changes you have been through (e.g. reaching independence, commitment, starting a family, reaching your plateau/peak and reaching old age). Compare your lifeline with that of your partner and discuss what they reveal about your relationship.

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  47. Neuro-Linguistic Programming (NLP)

Know what you want.

Be alert so you know what you are getting.

Be flexible to keep changing what you do until you get what you want.

There are six Neurological Levels which are all interconnected and influence each other. When focusing on desired results consider:

The desired environment – where and when.

Your behaviour/ thoughts/actions - what.

Your capability/skills – how.

Your beliefs and values – why.

Your identity – who.

Beyond identity – your place in the world spiritually.

There is no failure, only feedback. Keep a diary of your desired goals. Commit to actions to achieve them. Work daily on your plans. Think before you speak and move forward with caution and consideration for others’ perspectives as well as your own. It really helps to pause in conversation to give others space to process what has been said and to consider their reply. Effective listening is also a valuable skill. You can get your message across more effectively through stories than through any logical argument.

Association is when you see from inside yourself. Dissociation is when you see yourself from the outside. Being associated will bring strong emotions. Dissociation is good to distance yourself from a bad memory.

You selectively filter information from your environment in three broad ways – VAK and this can be extended to VAKOG:

Visual (sight and pictures).

Auditory (sounds).

Kinaesthetic (touch and feelings).

Olfactory (smell).

Gustatory (taste).

Try to spend one day exploring each of the senses (e.g. an olfactory day when you focus on every smell).

The senses are known as Representational Systems OR the ‘Modalities’ we use to think. The qualities of these modalities are called ‘Submodalities’. For example:

Visual submodalities: COLOUR (colour, black or white), BRIGHTNESS (light or dark).

Auditory submodalities: VOLUME (loud or quiet), CLARITY (clear or muffled).

Kinaesthetic submodalities: TEMPERATURE (hot or cold), TEXTURE (smooth or rough).

Olfactory submodalities: There seem to be seven primary odours [camphor-like, musky, floral, peppermint-like, ethereal (e.g. dry-cleaning fluid), pungent (e.g. vinegar-like) and putrid].

Gustatory submodalities: Sweet, sour, salty and bitter.

Predicates are words which link to a particular modality. For example:

Visual predicate – we see eye to eye.

Auditory predicate – turn a deaf ear.

Kinaesthetic predicate – she is a warm-hearted woman.

Olfactory predicate – I smell a rat.

Gustatory predicate – you are a sweet person.

Non-sensory language is sometimes known as ‘digital’. We tend to have a preference for one mode over the others. Everyday language you or others use gives clues as to your (or their) preference.

Listen to the words you or others use:

V (It appears that…/Sight for sore eyes…)

A (Music to my ears…/Tune in to this…)

K (Take one step at a time…/It hit home…)

Synesthesia is when one sense links with another (e.g. ‘The smooth taste of cream cheese’).

Accessing cues are those eye movements that indicate how a person is thinking – in pictures, words or feelings:

Eyes up and to the left – indicates a visual representation system/recalling images from the past, as seen originally.

Eyes up and to the right – indicates a visual representation system/constructing images about future possibilities.

Eyes defocused in position – indicates a visual representation system/could be recalling or constructing images.

Eyes down and to the left – indicates an auditory representation system/ often internal dialogue.

Eyes left or right, same level of gaze – indicates an auditory representational system/often internal dialogue.

Eyes down and to the right – indicates a kinaesthetic representational system/feelings and emotions.

An ‘Anchor’ is when a particular touch becomes associated with a particular experience (e.g. when the left knee is squeezed, it can be an anchor for the experience of being aroused). Bring to mind the experience you wish to anchor and associate it with a particular touch, or when an experience you wish to anchor occurs, associate it with a touch. You can bring to mind the experience whenever you use that touch.


You may experience time as a line going through you with the past behind you and the future in front of you, (In timeline). You are likely to be unaware of time passing and bad at time management.

If you see the timeline outside your body perhaps with the past to your left and the future to your right, (Through timeline). You are likely to be aware of time passing and good at time management.

Building rapport:

Get to know what is important to the other person.

Subtly introduce a few favourite phrases used by the other person.

Notice whether they like detail or the whole picture.

Identify their underlying aim.

Adopt similar body language, voice tone and gestures.

Respect their time, money and people close to them.

You can break rapport by mismatching someone (i.e. choosing to do something dissimilar to them).


If you raise your voice at the end of a sentence it will be perceived as a question.

If you keep your voice level it will be perceived as a statement.

If you lower your voice at the end of a statement it will be perceived as an order.

Try to use ‘Yes and…’ rather than ‘Yes but…’ For the former people remember what is said before and after, while for the latter they only remember what you said afterwards.

NLP Reframing – ‘As if’:

Act ‘As if’ something can happen and explore the behaviour to get there. Two examples of this are:

Time switch – step six to twelve months into the future and look back on how you overcame your problem.

Person switch – pretend you are someone you respect and consider what you would do if you could swap bodies for a day.

When people speak they tend to adopt three key processes with language:

Distortion – your own perception (e.g. ‘You’ll love this’).

Generalization – use of ‘always’, ‘musts’ and ‘shoulds’ (e.g. ‘I can’t …’).

Deletion – selective attention (e.g. ‘You’re better than me’).

The Meta Model uses a series of questions to challenge and obtain specific information from general statements. For example:

For a distortion – ask ‘What’s the evidence?’

For a generalization – ask ‘Always?’ ‘Never?’

For a deletion – ask ‘What, when, where, who, how?’

The Milton Model is the reverse of the Meta Model and uses deliberately vague statements to take someone into a trance (an altered state of consciousness), in which they can make changes to solve their own problems. Distortions, generalizations and deletions are used to make language vague, such as:

For a distortion: ‘With every breath you will feel more relaxed’.

For a generalization: ‘You can become more successful’.

For a deletion: ‘You are ready to listen’.

Make positive statements: The brain ignores the ‘don’t’ and thinks ‘do’. It does not distinguish the negatives, so try to make positive statements the norm. No behaviour can exist without positive benefit. So look for the positive intent of your negative behaviour, and see if it can be met by alternative more helpful behaviour.


What do I want? (Outcome).

How can I get it?

What are the possibilities?

What can I learn from my results? (Feedback).

What am I assuming here?

Cartesian-Coordinates - these are four questions which can guide you in making a decision:

What will happen if you don’t?

What will happen if you do?

What won’t happen if you don’t?

What won’t happen if you do?

To deal with problems compare the problem situation with a similar one where you do not have the problem and note the critical differences.

See a problem from:

First position – your own viewpoint (subjective).

Second position – the other person’s viewpoint (empathic).

Third position – as a mediator between yourself and the other person (objective).

Remember the saying: ‘If you always do what you have always done, you will always get what you have always got’.

If something is not working, do something else.

Focus on the result and look for patterns in exceptional productivity. Ask: ‘How did I do that?’ Network, delegate as much as possible, and pursue what you are best at and enjoy. Excellence in a few things is better than competence in many. Take on a wide range of projects but only persist with those that show good results. Get adequate relaxation and recreation and always stretch yourself for success.  

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                 48. Communication Training

Good Non-Verbal Communication:

Make regular eye contact.

A touch on the shoulder can indicate warmth.

Smiles can show positive feelings.

The tone of voice can make you sound cold, angry, warm or pacifying.

The closer the partners are the less they need to raise their voices. If they need to shout the speaker may appear angry or impatient.

Good Verbal Communication:

Plan ten minutes with some extra time when you will not be disturbed.

Share the ten minutes equally between you and your partner with five minute periods each.

Set a timer at ten minutes or twice at five minutes so you can change over.

Decide who will start and take turns in subsequent sessions to give you each the chance to start the discussions.

Agree to a truce for the duration of the discussion.

If you begin to argue, stop and plan a replacement session.

Decide on the topic to be discussed (e.g. a book).

Stick to the topic being discussed.

If you cannot agree then end by ‘agreeing to differ’.

Start sentences with ‘I’ to show you feel strongly about the matter.

Speak in brief, clear and simple sentences, leaving a gap for your partner to respond.

Avoid discussing the past and focus on the present and future.

If you make a negative statement, end with a positive comment.

Be warm and positive, and request different action in the future rather than complaining or dwelling on the past.

Avoid ‘mind-reading’ (telling your partner what you think they are thinking).

Make sure you let your partner know that you understand what they are saying (reflective listening) and feeling (empathy).

You are the only person you can change. By changing your own behaviour, your partner is likely to change their behaviour in response.

Go to separate rooms after a discussion and spend some time alone.

Aim to increase the sessions to twenty minutes and make them more frequent.

Skill Deficit or Performance Deficit?

You need to ascertain whether you have a skill deficit or a performance deficit. If the former is the case, you will have problems communicating with several people, and need to learn some basic communication skills. When you have a performance deficit, you will already have basic communication skills but will be unable to deal with certain situations. You need to identify the factors that hinder your ability to communicate effectively in these situations, for example, are there certain topics of discussion that tend to end in arguments? Consider how you could cope in these circumstances.


Conflict can range in intensity from disagreement to the extreme of physical violence. Resolve conflict by diffusing anger and using problem-solving skills.

See Program 6: Overcoming Anger and Problem-Solving.

Conflict avoidance is also a communication difficulty. In this case you need to:

Understand what maintains the problem.

Learn assertiveness and communication skills to aid problem-solving, and manage anger.

Practise these skills repeatedly.

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                 49. Negotiation Training

Follow the instructions for Communication Training but this time you each need to have a specific complaint about everyday life as the topic to discuss. Focus on the future and place any complaints in the past.

Take turns to: State your complaint as a positive request for the immediate future, and then change the request into a task. Specify what to do, when, where, how and how often. Put the task in writing.  

End each session with an equal number of written tasks each – it is best to start with one written task each. You will each be requesting something of your partner.

In the next session monitor how well you have each done with your tasks. Note any improvements.

You need to do these sessions for several weeks to notice any positive change in the way you treat each other.

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                  50. Timetabled Activities

When the way a couple spend their time is causing conflict, a timetable of activities may be helpful, for example, when one partner watches a lot of sports on television while the other wants to socialize; or one partner may desire to have sex more frequently.

Follow the instructions for Communication Training to set up a time-limited discussion.

Specify the activities you both want to timetable.

The partner who finds the activity a problem should clarify this and state what they would prefer to be done.

A timetable needs to be agreed which has a fair division of both the disliked and preferred activities or the activity one of you wants increased or decreased.

A rewarding alternative needs to be provided to the partner who is giving up something.

Decide when to do the activities.

Plan how long and how frequent the activities should be.

You may like to spend time together each doing both the preferred and disliked activities – a mutual timetable.

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                  51. Reversed Role-Play

This technique can help you to empathize with your partner:

Plan a time when you will not be disturbed.

Start a discussion about a trivial topic that you disagree on but take your partner’s point of view.

At the end of ten minutes resume your own point of view and discuss how it felt to take your partner’s side.

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                  52. Time-Limited Trivial Arguments

If communication/negotiation training is not possible then try a time-limited argument on a trivial issue, under a ‘truce’ arrangement. This technique is particularly helpful in relationships where couples find it hard to express their feelings.

Avoid confrontation, blaming or withdrawing as this may result in a separation. If the argument starts to escalate, stop and go to spend some time alone to cool down in separate rooms.

Plan a time when you will not be disturbed and set a timer for ten minutes.

Choose a trivial topic you disagree on.

Argue without getting too serious.

Stick to the topic.

Do not insult or call each other names.

When the timer goes off, stop arguing and go to separate rooms to spend some time alone.

It is OK to discuss how it felt to argue but not to restart the argument.

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                 53. Triangles

These are formed when you and your partner are affected by outside factors (e.g. children, relatives, friends, work or unshared interests). In such circumstances you need to be clear about the boundaries around you as a couple. In most cases triangles are not a problem (e.g. a mutual friend).

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                  54. Social Skills Training

Lack of social skills may prevent you from getting into relationships whether for friendship or sex. It helps to use greetings, smile, make eye contact, not sit too far away or too near and use a relaxed tone of voice. Talk about general topics, about you, and about the other person. Apologizing when clearly wrong is more effective than making excuses.

Make a list of useful topics for discussion in advance in case the conversation dries up (e.g. discuss items of news, television programmes, recent sports events). Try to answer questions with more than just a ‘yes’ or ‘no’ and allow the possibility of further discussion of new ideas. Do not make the conversation too long when you first meet someone. If you like them, then arrange to meet again and keep them interested in what you have yet to discuss as well as what you have discussed.  

Practise expressing your feelings using the ‘When…then’ format, for example: ‘[When] you come home late, [then] I worry you are with another woman’. Using a mirror practise a range of facial expressions (e.g. happy, calm, annoyed, angry, furious – you could also include: anxious, guilty, ashamed, and depressed). Use different facial expressions for each different mood state.

Learn to disagree by being direct, honest and asking for clarification of the other person’s viewpoint. Express your feelings simply as ‘I’ statements without violating the rights of others. Observe and learn from how socially skilled people handle difficult social situations.

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                 55. Making Your Love Last

                  Task 1:

Were your parents openly affectionate?

Did they argue in your presence?

Did either or both of your parents work?

Who did the housework?

Were there any major crises in their relationship (e.g. an affair or bereavement)?

In what way did they discipline or show affection to you and your siblings?

Do you think parenthood made them happy?

If your parent was single due to death, divorce or from never marrying, how do you think this affected you?

Task 2:

For the list below write whether it should be done by the man or woman in the relationship or be shared:


Cleaning the kitchen.

Cleaning the bathroom.



Washing up.

Doing the laundry.


Sweeping floors.


Household budgeting.

Paying household bills.


Cleaning the windows.

Maintaining the car.



Feeding the baby.

Changing the baby’s nappy.

Bathing the baby.

Task 3:

Write down anyone your partner reminds you of (e.g. a family member, friend or celebrity) then compare with your partner’s list and discuss how you both feel about these lists.

Task 4:

Spend half an hour together discussing why you love each other and what your expectations are of a loving relationship.

Task 5:

Swap roles with your partner and describe how you think they see you then later discuss to what extent you were right.

Task 6:

Formulate a statement about what marriage means to you.

Task 7:

Write down on separate sheets what you think constitutes the following roles then compare with your partner:





Task 8:

Write down:

What you desire from the relationship.

What your priorities are in life.

What makes you angry.

Task 9:

Note the elements that make up a wedding (e.g. dress, cake, ceremony, reception) and rate each on a scale of 1-5 (where 1 is, not important and 5 is essential). Discuss with your partner how you each feel about these elements and any differences of opinion.  

Task 10:

Make a list of family and friends. Write next to each person’s name how frequently you would like to see them after your wedding and compare with your partner.

Task 11:

Write down how marriage will affect:


Your partner.

Both of you.

Task 12:

Discuss with your partner whether you want children, how many and any preference for boys or girls. Should the mother work full-time/part-time or not at all? Should the father share in the caring for the baby? If not, what should be the role of the father?

Task 13:

Write what you like about your relationship now before marriage and tick anything you hope continues after your wedding; cross out anything you think will stop.

Task 14:

Write out your marriage vows then discuss these with your partner.

Task 15:

How do you manage your finances? Do you budget, save or go on spending sprees and never have enough money? What would you do if you won £5000 pounds? Write a statement about what money means to you (e.g. security).

Task 16:

Write down the feelings you think would be inappropriate for a man (e.g. weepy, frightened). Then list the feelings you think a woman should not display (e.g. aggressiveness). Next, note the feelings you experience most frequently and compare with your partner.

Task 17:

Good communication involves talking and listening assertively, and showing acceptance when others differ to you in their opinions. Discuss why this is good communication.

Task 18:

When difficulties arise in your relationship you can look back on the good times to help you through the problems. Hence, it is a good idea to build and keep a diary of positive experiences. Talk, listen, be kind, generous and have fun together; these will make it easier to overcome any crises that may occur in the future.

Task 19:

Set a date every week to spend quality time with each other and try to go out together at least once a month.

Task 20:

Take turns with your partner to talk about your feelings. Spend thirty minutes each on this exercise.

Task 21:

Note the things that make you feel loved then swap lists with your partner. Try to find opportunities to do the things your partner would like.

Task 22:

Daily request one thing you would like your partner to do for you (e.g. washing up or massage).

Task 23:

Once in a while give each other presents that do not cost anything but are symbolic.

Task 24:

Try to be attentive when your partner leaves or arrives.

Task 25:

If you are having difficulties in your marriage try acting ‘As if’ you are happily married and see if it makes a positive difference.

Task 26:

Arrange coins to symbolically represent your relationships. Which coin would you use for yourself? Which would you use for each person in your life? How would you arrange the coins? Discuss with your partner the feelings that give rise to this arrangement.

Task 27:

We are all part of units. Each unit of people is surrounded by a boundary which keeps people ‘in’ and ‘out’. You feel you belong and are safe inside this invisible line. If you are outside the line, you can feel intimidated. You are usually unaware of these boundaries and drawing diagrams can help you to understand why you and your family are experiencing difficulties, especially if you are a blended family.

Write down the names of family and friends then let each person draw a boundary around those they include in their unit. By comparing these diagrams you may be able to identify particular problems (e.g. someone may not belong in your unit, the desired unit, or any unit at all)!

Task 28:

If anger is a problem in your relationship, try keeping an anger diary in which you note the angry incidents and what triggered them (e.g. physical reactions – headache; or emotions/feelings – guilt).

Task 29:

Take turns to discuss your earliest memories of:

Someone being angry with you.

Your parents being angry with each other.

You were feeling angry.

If your family did not argue, what feelings were you aware of instead?

Task 30:

Make a list of things that irritate you and write:

What you could do to deal with these irritants.

What others could do to deal with these irritants.

If nothing can be done, how you could learn to endure these irritants.

Task 31:

Learn to communicate and negotiate effectively when angry, rather than playing a win-lose game in which you see yourself as the one deserving to win.

See Communication Training and Negotiation Training.

Task 32:

Prepare for an argument by spending time with your partner when you are not angry, to take turns expressing your feelings in ‘I’ statements. These show that something is important to you whereas ‘You’ statements place the blame on your partner who is then more likely to become defensive.

Task 33:

Next time you have an argument, limit it to fifteen minutes. Take turns of five minutes each to give your views on the matter. Spend the last five minutes negotiating an agreement. If this is not possible then ‘agree to differ’ until another time.

Task 34:

If you have a major disagreement with your partner, try writing possible solutions and swap lists. Discuss one thing you can each do to solve the problem. Daily make small concessions toward meeting in the middle.

Task 35:

List the reasons why you fell in love with your partner. Note if any of these things have changed and discuss with your partner what has changed and your subsequent feelings.

Task 36:

Write down the main aspects of your life (e.g. home, partner, children, money, work, and social life). What were the feelings associated with these before your relationship? How do you feel now? What do you want most from life? Discuss your views and any changes with your partner.

Task 37:

Consider how you think having a baby will impact on the main areas of your life – home, work, social life. If you already have a baby or children note how this affects the different areas of your life. Discuss your feelings with your partner.

Task 38:

If you have a baby, what are the good and bad things about your baby? If you cannot have a baby, talk to your partner about your grief for this loss and try to find a new purpose in life without being a parent. List the things you can do only if you do not have children and implement some of these ideas. Discuss the alternatives of adoption, fostering, surrogacy or artificial insemination by donor.

Task 39:

When one of you has had an affair and you both want to stay in the relationship, it can help to set aside an hour a week for the wronged partner to talk about how they feel without being interrupted by the person who has had the affair. After a few weeks the person doing the talking is likely to feel they have said all they want to say.

Task 40:

If you are grieving about a death, it can help to write a letter to the deceased loved one saying all the things you wish you had said, and keep it safe.

Task 41:

If you are leaving home, discuss your feelings with your partner.

Task 42:

If you are a working mother you can improve the way you deal with the demands on you by regularly spending some time alone doing things you enjoy.

Task 43:

Working mothers need to sit down with all the members of the family and together make a rota of all the household jobs which need to be done – stating who does what and rotating the worst jobs so no one has to do them all the time.

Task 44:

Spend time alone with your partner regularly doing something enjoyable – this can bring you closer to each other.

Task 45:

If you are no longer working after doing so for years, you may find it helpful to use an activity schedule to optimize how you spend your time.

See Planning an Activity Schedule.

Task 46:

If your children have left home, discuss with your partner how you feel about the subsequent changes to your life and how you would like your relationship as a couple to be like in the future.

Task 47:

If you are both retired, make a list of all the fun things you could do together now, and then try to do as many of these as you can.

Task 48:

Discuss with your partner what each of you thinks the opposite sex likes sexually (e.g. looks, clothes).

Task 49:

List the different ways in which you could touch each other and talk about what feels good to you (e.g. kissing, licking, and stroking).

Task 50:

Discuss with your partner how you felt when you first heard about sex and when you started developing into an adult. Take turns describing how you experience sex at present and how you would like it to be in future.

Task 51:

What do you like about your sex life? What would you like to change and how could you do this? Discuss how you can spice up your love life by considering a variety of ways of love making and doing the ones you find exciting. Share with your partner any sexual fantasies you have had and try constructing a mutual fantasy.  

Task 52:

Try writing a Love Letter when you feel overwhelmed by a situation. Express the following feelings:

I am angry that/about…

I am sad…

I am afraid…

I am sorry…

I love you…

Then write a Response Letter expressing how you would like your partner to respond. Finally, share your Love Letter and Response Letter with your partner. [John Gray]  

Task 53:

When asking for support from your partner:

Avoid using ‘can’ and ‘could’ which are merely questions gathering information.

Use ‘will’ and ‘would’ which are requests.

Be brief and direct.


Asking for things you are already getting from your partner and showing appreciation when you get what you request.

Accepting graciously your partner saying ‘No’ to your requests by asking for things you know they will not do.

Asking assertively – stay silent after a request, in anticipation of your partner saying ‘Yes’. If they resist then match their resistance. For example, if your partner says they are tired, do not try to prove you are more tired; match this with ‘I am also tired’ and repeat your request then remain silent. [John Gray]

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                  56. Medication

Medications used can be:



Mood Stabilizers



Drugs for Sexual Dysfunction

Also - Electro-Convulsive Therapy

        - Psychosurgery

Neuroleptics are sometimes called ‘Anti-psychotics’ or ‘Major tranquillizers’ and used to treat psychoses/schizophrenia, and in low doses for anxiety. ‘Typical neuroleptics’ include: Chloropromazine (Thorazine), Haloperidol (Haldol), Thiothixene (Novane) and Trifluoperazine (Stelazine). Newer ones are often called ‘Atypical neuroleptics’ such as: Clozapine, Resperidone, Amisulpride and Olanzepine. Side effects are salivation, constipation, drowsiness, weight gain, reduced sexual desire, and diabetes. Neuroleptics can induce involuntary movements (Tardive Dyskinesia). Anti-psychotic drugs affect the neuro-transmitter dopamine in the brain.    

Anti-Depressants used are:

Monoamine oxidase inhibitors

MAOI’s (e.g. Phenelzine [Nardil] and Isocarboxazid [Marplan]).

Tricyclic anti-depressants

TCA’s (e.g. Imipramine, Desipramine, Clomipramine [Trade name Anafranil], and Amytriptyline).

Selective serotonin re-uptake inhibitors

SSRI’s (e.g. Fluoxetine [Prozac], Citalopram [Celexa], Paroxetine [Paxil], Sertraline [Zoloft], Escitalopram [Lexapro] and Fluvoxamine [Faverin/Luvox]).

Serotonin and norephinephrine re-uptake inhibitors

SNRI’s (e.g. Venlafaxine [Effexor XR], Desvenlafaxine [Pristiq] and Duloexetine [Cymbalta]).

SSRI’s are thought to have fewer side effects than the Tricyclics, and side effects of anti-depressants are less severe than those caused by neuroleptics. SSRI’s combined with other drugs, for example: Lithium [mood stabilizer], and the amino acid L-tryptophan - can lead to increased effectiveness. However, there may be further side effects from this mixture of drugs.

Tricyclic anti-depressants and Monoamine oxidase inhibitors can be lethal in overdose and should not be given to suicidal clients – newer agents are safer. With MAOI’s certain medications (including illegal medications) and foods can cause a hypertensive crisis (sudden increase in blood pressure) and there is a risk of stroke.

Anti-depressant drugs affect the neuro-transmitters nor-epinephrine and serotonin in the brain.  

Mood Stabilizers used include Lithium and Lamotrigine and Anti Convulsant Mood Stabilizers such as Valproate and Carbamazepine [Tegretol].

Anxiolytics anti-anxiety drugs are used for short-term relief of severe and disabling anxiety and include:

Benzodiazepines – minor tranquillizers/sedatives (e.g. Diazepam [Valium]).

Non-Benzodiazepines – (e.g. Buspirone [Buspar]) which lack the sedation and dependence associated with benzodiazepines.

Stimulants can be used for medical purposes and include Caffeine, Methylphenidate [Ritalin] and Methamphetamine [Desoxyn].

Drugs for Sexual Dysfunction: Viagra [Sildenafil Citrate] and Cialis are used to treat male erectile dysfunction.

Electro-Convulsive Therapy (ECT) can be an effective short-term treatment for depression when medication treatments have failed. Following acute treatment with ECT, patients are placed on medication.

Psychosurgery is performed as a last resort, and in only the most extreme cases when all other forms of treatment have failed and where, due to their disorder, the patient is likely to cause harm to themselves or to others. It involves permanent damage to the neural tissue; the 'cingulotomy' is a newer less inavsive procedure.

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57. Relapse Prevention


See Medication

Relapse is a return to old habits after a period of cessation. A lapse is a brief slip that may or may not lead to a relapse. Do not be discouraged by a relapse but learn from the opportunity. Smoking research shows that an average of ten serious quit attempts occur before a person successfully stops smoking tobacco. You need to learn to attribute a relapse to the situation rather than to yourself. Make a list of people you can contact for support before or in the event of a relapse.


What have you learned from this self-therapy? What has helped you?

What will you do if a setback occurs? Use setbacks as an opportunity to learn how to deal better with such situations in future.

What are your early warning signs of pre-lapse, lapse and relapse?

What could cause problems in the future? Note any high risk situations. How would you deal with them and generally maintain progress?

What is the worst case scenario and how could you cope?

What goals can you set for the coming month?

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