Coping Strategies Counselling Advice

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 back 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 towards 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 set backs.
   • Deepen your own 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 – improve: living skills, physical lifestyle, interpersonal relationships (especially get more support from your partner and make sure s/he understands 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:
     1. Denial – are you and your partner denying that anything is wrong or that something was wrong but will not happen again;
     2. Projection – are you accusing each other of your own inadequacies or blaming each other for the behaviours that cause your inadequacies;
     3. Sabotage – is your partner unconsciously trying to sabotage your recovery?;
     4. Triangling – are you forcing your child to take sides? Do you understand the detrimental effects on your child? ;
     5. 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:
     1. 4 or more self defeating beliefs (beliefs that place responsibility on your shoulders for how your parents feel);
     2. more than 10 feelings that are connected to beliefs that are of guilt, anger, fear or sadness;
     3. 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. You need 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 sitting 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:
     1. the aggressor/s;
     2. the other parent or both parents;
     3. the damaged child from the adult self;
     4. a fairy tale in the third person about your life with a happy ending;
     5. to your partner or ex-lover;
     6. 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 change with therapy. See ‘Overcoming Childhood Abuse’ in the Forward Counselling Advice Service.
   • 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:
     1. Set specific behavioural goals e.g. 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.
     2. Establish reward systems for all successes no matter how small.
     3. Keep records of your changes perhaps in a diary.
     4. 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. You need to have the courage to experiment and take risks. In this way you will find freedom from yourself and your habitual, enslaving misconceptions. You need to accept your place in the world with your limitations and beware of worshipping anyone else. You need to be aware that there is always the opportunity for growth and that you should never think you have the final answer.
   • For permanent change it is necessary to 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.
   • You need to 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 and 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:
     1. a need to disguise your real thoughts and feelings;
     2. hiding behind your public mask;
     3. making it hard for each other to be open by becoming angry when one partner opens up;
     4. avoiding openness by verbal hints and hurts or withdrawing into a shell.
   • Explore whether in choosing a partner you have attempted to fulfil 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. Set short term goals and attain them. Have an active approach to this advice and practice your new behaviours until they replace the old.
   • What behaviours do you want increased/maintained? Be aware that:
     1. Positive reinforcement is when a partner does something and the consequence is pleasant or desired.
     2. Aversion escape is when a partner does something and as a consequence something bad ceases.
     3. 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. You need to focus on behaviours causing mutual pleasure.
   • In establishing ‘replacement behaviours’ you and your partner need to be aware of:
     1. The things your partner does that bring pleasure.
     2. The behaviours that do not bring pleasure.
     3. The behaviours that you would like to see changed in your partner.
   • You need to concentrate on what is liked rather than what is not liked.
   • Concentrate on behaviours you want increased/maintained rather than those you want decreased.
   • You need to consciously practice feeling states e.g. ‘I feel happy when…’
   • Many people never feel fulfilled. They live in the safety of established patterns. They 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 needs 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 3 stage shock process of grief over loss of a loved one or loss of any form:
     1. shock/numbness;
     2. a period of suffering or disorganization;
     3. 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.

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3. General Counselling III
   • Determine whether you are neurotic – an inability to interact effectively in a social setting – 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 fulfilment of the exceptional. You need to:
     1. live in the ‘now’;
     2. be responsible for you;
     3. selfishly satisfy your needs;
     4. give yourself credit for effort as well as success;
     5. 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 e.g. ‘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 and are comfortable with all human emotions. They travel in confidence.
   • You need to take the five steps to positive thinking:
     1. To accept you.
     2. To be as you.
     3. To forget you (not be self-centered).
     4. To believe in you.
     5. To belong to you (enjoy a sense of community).
   • You should not think you are better than anyone else. You need to 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’.
   • 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.
   • You need to 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 a way 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.
   • You need to know 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. 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:
     1. Independence versus dependence – in times of stress we may become dependent but are taught that independence shows maturity.
     2. Intimacy versus isolation – we may desire to be close to someone but fear rejection.
     3. Co-operation versus competition – there is much emphasis on competitiveness but we are urged to co-operate with others.
     4. 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.
   • Explore defensive strategies:
     1. Denial – an unpleasant external reality may be denied to exist.
     2. Repression – threatening impulses or memories may be excluded from action or conscious awareness.
     3. Rationalization – assigning logical or socially desirable motives to our behaviour so that we ‘seem’ to have acted rationally or properly.
     4. Reaction formation – concealing a motive for behaviour from oneself by giving strong expression to it’s opposite.
     5. 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.
     6. 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:
     1. Deviation from statistics – statistically infrequent.
     2. Deviation from social norms.
     3. Maladaptiveness of behaviour – behaviour has adverse effects on individual or society.
     4. Personal distress.
   • Normality is defined by:
     1. How adjusted an individual is to the world.
     2. Efficient perceptions of reality.
     3. Self-knowledge – how aware an individual is of his or her own motives and feelings.
     4. Ability to exercise voluntary control over behaviour.
     5. Self-esteem and a feeling of acceptance by others.
     6. Ability to form affectionate relationships.
     7. Productivity.
   • 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. You need to monitor your own behaviour using techniques of:
     1. Self-reinforcement – rewarding yourself for achieving a specific goal.
     2. Self-punishment – arranging some aversive consequence for failing to achieve a goal.
     3. Controlling stimulus conditions – controlling/avoiding situations/stimuli that elicit the maladaptive behaviour.
     4. Developing incompatible responses – record stimuli that elicit maladaptive behaviour, and 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:
     1. There are three awareness zones: awareness of – outside world; inside world; fantasy activity. When you focus on one your awareness of the others decreases.
     2. Focusing ability – your awareness acts as a searchlight. What you focus on becomes clear while other things fade.
     3. Generalization – this is fantasy activity of the mind e.g. now I see the whole room. Awareness is sharper.
     4. Selection – you selectively focus on things relevant to you.
     5. Avoidance – focusing on certain types of experience is a way of excluding others.
     6. Interruption in flow of awareness is often to avoid something unpleasant.
     7. Withdrawing into inside or fantasy awareness can give rest and support and reveal unfinished situations.
   • Consider how you can have in-depth communication with others. You need to know that when you are honest with yourself and get in touch with your experiencing and express it as your experiencing, others respond with trust and respect.
   • You need 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:
     1. Pretend listening – listener only hears key words and phrases and may interrupt the speaker. It is disrespectful.
     2. Passive listening – listener tries to listen without becoming emotionally involved.
     3. Interactive listening – two way communication, making effort to understand.
   • Effective speaking consists of:
     1. Being direct – taking responsibility for what we have to say to our partner and being personally available to hear their response.
     2. Being specific – making clear statements and avoiding ambiguity.
     3. Being brief – concise communication is more memorable.
     4. Sending consistent messages – our voice, facial expression and body posture should reflect the same message we are verbalizing.
     5. Using ‘I’ statements – these show the speaker is taking responsibility for the feelings and thoughts s/he expresses and not just dumping them on their partner e.g. ‘I am feeling hurt’ rather than ‘ I feel YOU are angry’.
   • 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 each reveal about yourself and your feelings and how much did you keep hidden?; who took the most active part in this getting acquainted?
   • You need to 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 s/he does 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’?
   • Spend 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.
   • You need to confront your negative feelings and 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. You need 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.

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5. Challenging Anxious And Negative Thoughts

   Dealing With Psychological Aspects: Challenging Anxious Thoughts

   • Thinking affects your feelings and how you feel affects your thinking. By altering your thoughts you will feel better.
   • You need to recognize the different types of thoughts which include ideas, expectations and attitudes.
   • Worrying thoughts become a difficulty when you cannot get rid off 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 three 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) and write down thinking biases.
   • You need to recognize bias in your thinking so that you can rectify your thoughts. Patterns of biased thinking include:
     1. being personally affected by things;
     2. taking the blame when you are not at fault;
     3. mind reading – thinking you know someone’s thoughts when you do not;
     4. discounting the positive;
     5. jumping to negative conclusions – interpreting things without evidence;
     6. emotional reasoning – an over-reliance on feeling to guide judgments;
     7. catastrophizing – predicting the very worst;
     8. over-generalizing – you notice something true and make generalizations about it;
     9. predicting the future;
     10. labeling – calling yourself names;
     11. wishful thinking.
   • Consider how you can challenge your worrying thought by finding alternative ways of thinking. Think about the reasons both for the worrying thought and against maintaining it. What is the worst case scenario and how could you cope? Try to form a more rational and constructive view of the circumstances. Re-rate your distress.

   Feelings and Thoughts

   • 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 anxious 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 anxiety.
   • 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.
   • 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 three columns to separate triggering events, beliefs and key thoughts, and feelings.
   • 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 a 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 your self “Even if this does not help, what will I lose from trying?”

   Challenging Negative Feelings and Thoughts

   • To fight negative feelings and thoughts you need to be rational (logical, work like a detective) and compassionate (warm and friendly).
   • Often we do not see that there is evidence for and against a negative belief.
   • 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 can do experiments to obtain more evidence for and against your thoughts and beliefs; test things out and practice 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 not anxious 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 pros and cons and the advantages and disadvantages of altering your circumstances.

   Types of Negative Thinking

   • The manner in which you think about things can cause your emotional problem to increase rather than decrease.
   • You should try to concentrate on and gain knowledge of your negative thoughts.
   • The types of negative thoughts that arise in emotional problems include: catastrophizing (predicting the very worst), jumping to negative conclusions (interpreting things without evidence), emotional reasoning (an over-reliance on feelings to guide judgments), ‘I must’(these thoughts involve feelings of being compelled to do something), disregarding and disbelieving the positives, disregarding and disbelieving others, increasing the strength of the negatives by dwelling on them, all-or-nothing thinking (black-and-white thinking) and over generalizing (you notice something that is true and make generalizations about it). It is possible to successfully challenge all these thoughts.
   • From the different types of negative thinking given above try to recognize the ones relevant to you.
   • As you record your thoughts try to become aware of the type of thinking you are employing. You need to get as much practice 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 if these types of negative thoughts 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? You need to 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.

   Further Challenging Negative Thoughts

   • To help you focus on controlling negative thoughts use flash cards 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 and compassionate self. Ask yourself what each would say respectively and write down your thoughts.
   • Try to change your internal images so that they become more comforting and healing.
   • 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. 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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6. 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 behaviour:
     1. Aggressive - you may be forceful in expressing your opinions, feelings and wants.
     2. Passive - your opinions, feelings and wants may be withheld completely or partly.
     3. 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 for 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.
   • There are five steps to being assertive:
     1. What do you want? ;
     2. What is fair? ;
     3. Be clear in asking for it;
     4. Contemplate and be ready for the risks;
     5. Stay calm
   • Practice 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:
     1. Consider your rights and wants.
     2. Unless spontaneous action is required, arrange a mutually convenient time to discuss your problem with the other person.
     3. Define the problem as specifically as possible.
     4. Describe your feelings using 'I' messages, to give the other person an understanding of how important the issue is to you.
     5. Make your request in one or two simple but firm sentences.
     6. Give positive reinforcement to get what you want e.g. 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 renegotiate.
   • Avoid being manipulated - techniques include:
     1. 'Broken Record' where you choose a concise assertive statement to say over and over to get your message across.
     2. Delay responding to a challenging statement until you are more prepared.
     3. Inviting criticism may reveal what is troubling the other person.
     4. When someone puts you down, acknowledge something you can agree with in their criticism and ignore the rest.
     5. 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:
     1. Your thoughts - state the facts as: 'I think…'
     2. Your feelings - express as 'I' statements: 'I feel…'
     3. Your wants - specify behaviour change as: 'I want…'
   • You need to develop assertive body language. Practice the following basic rules in front of a mirror so that you learn how to apply them to problem situations:
     1. Maintain eye contact and an erect body posture.
     2. Speak clearly and firmly.
     3. Emphasize what you are saying with gestures and facial expressions.
   • Learn to listen assertively:
     1. Make sure you are both ready to listen.
     2. Listen giving the other person your full attention and ask them to clarify if necessary.
     3. Let the other person know you have heard what s/he has expressed to you.
   • Practice 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.

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7. Dealing With Interpersonal Relationships
   • Interpersonal relationships may have caused your emotional problem or may be preventing you from recovering – in any event interpersonal relationships will be affected by your emotional problem.
   • You need to understand your personal relationships and be able to deal with them effectively.
   • Draw interpersonal maps for:
     1. How your interpersonal relationships are at present;
     2. How your interpersonal relationships might be now if you did not suffer from your emotional problem;
     3. How your interpersonal relationships will be in 10 years if you continue to suffer from your emotional problem;
     4. 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 yourself in the middle of the map in a circle.
   • Place each person’s name in a circle on the map, around you in the middle – the closer the relationship to you, the closer the circle to you.
   • Join these circle’s 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:
     1. who initiates and terminates contact;
     2. are you happy with how often you see this person?;
     3. who decides what to do or what to talk about?;
     4. is there a balance between giving and receiving?;
     5. do you want to alter the relationship in anyway?
   • Consider questions such as:
     1. who could I confide in and get advice from?;
     2. who would be there for me if I fell ill?;
     3. 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 way you want to change your relationships.
   • Two important reasons for making changes are:
     1. A balanced and supportive social network is necessary for your well-being;
     2. 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.
     

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8. Removing The Obstacles To Intimacy
   • 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 overgeneralising?
   • Social inadequacy can be an obstacle to intimacy. Apply your assertiveness skills to your social and work life and observe how socially skilled people handle situations in particular difficult ones. Rehearse your social behaviours so that you are comfortable with them.
   • 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 ‘Overcoming Social Phobia’ in the Forward Counselling Advice Service.
   • It is possible to become over-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.
     

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9. Stress Awareness Training
   • You need to monitor your stress and become familiar with what sets it off and the feelings, thinking and actions associated with the anxiety. You can do this by keeping a diary. When you feel anxious note the date and time. What was the event? Rate your distress 1-10 (1 is no distress and 10 is extreme panic). What caused your anxiety? What was your response to cope with the problem? Re-rate your distress.
   • After two weeks of monitoring your stress levels you should become aware of what triggers your distress, your bodily feelings and thoughts when distressed, how your distress levels vary with different situations, what you tend to do when distressed and what is the best way for you to cope with your distress.
   • Make two lists – one of short-term only coping strategies and the other of long-term coping strategies. You can refer to these when you feel stressed. Try to incorporate more of the long-term strategies into your set of coping techniques and attempt to gradually abandon your short-term methods.
   • Avoid turning to stimulants such as alcohol, caffeine and nicotine as coping methods. These have unpleasant effects in the long-term.
   • Study your diary to determine what drives your cycles of distress. Is it bodily, psychological, behavioural or social?
     

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10. Controlled Breathing And Relaxation Techniques
    1. Dealing With Bodily Experiences: 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 practice 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.
       • In order to be effective you need to practice this exercise repeatedly.
         
         
    2. Dealing With Bodily Experiences: Relaxation
       
       
       • 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 practice your relaxation exercises. Start by lying down and later you can try sitting or standing. Control your breathing.
       • 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.
         
         
         1. Progressive Muscular Relaxation (PMR) – 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 – arc your back then relax and repeat; shoulders/neck – bring your shoulders up and in and press your head back. Relax and repeat; arms – stretch out your arms and hands. 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 then when you are relaxed think of something calming to relax your mind. Get up slowly and gently.
         
         
       2. You should practice PMR twice a day until you feel relaxed after the exercise.
          Shortened PMR – 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.
       3. Simple Relaxation Routine – 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 practice 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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11. Distraction Techniques

    Dealing With Psychological Aspects: Distraction

    • 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 or studying how someone is dressed.
    • Mental Exercise – Formulate a phrase, picture or mental exercise that distracts you e.g. redesign your home, imagine your dream home in detail or recite poetry.
    • Develop a set of distraction techniques for different occasions that are suited to your needs e.g. If you get stressed at interviews then physical distraction will not be helpful.
    • Make two columns – in one write down the situation causing anxiety and in the other your chosen distraction method.
    • Practice your distraction techniques when you are not anxious and try to catch your anxiety at an early stage.
      

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12. Mood
    • Your mood affects almost every area of your life. Irregularities in your mood lead to feeling irritable with no obvious trigger. When this is the case almost anything can set off your anger.
    • The main factors influencing your mood and how you can attain a stable good mood are considered below.
    • Your body wants to eat and sleep regularly so you need to form a good circadian rhythm or daily routine. Make a list of your rising time, mealtimes and bedtime and try to keep to within 30 minutes of these times either way. Record the actual times you eat and sleep in a diary.
    • Exercise is good for you and it need not be strenuous – do not undertake strenuous exercise without consulting your doctor. Wear comfortable and even stylish shoes and think of exercise as important. Exercising will increase your energy. Try exercising earlier in the day if you are usually too tired in the evening. You should get as much exercise as you want. Keep a diary of how much exercise you are getting. This can be part of your routine (e.g. walking between places) or planned timetabled exercise (e.g. going for a swim).
    • Eat a balanced diet and make sure you chew your food well to digest it properly. Drink plenty of water. You should eat mostly fruits and vegetables, least of high fat foods such as cake and chocolate and a moderate amount of foods such as bread, rice and potatoes and high protein foods such as meat and fish with less of the latter category than the former.
    • Cut down on your stimulant intake to about three cups of coffee a day. Reduce your alcohol intake to 21 units a week for a man and 14 for a woman. Go easy on nicotine and other ‘recreational’ drugs. Try to get down to your recommended alcohol intake. If you need help to do this your doctor may be able to suggest someone or you could contact Alcoholic Anonymous (contact number available from local phone book) – you do not need to be drinking excessively to enlist their help.
    • Get into the routine of getting a good night’s sleep. Rise and eat regularly and reduce your stimulants and alcohol intake. Get sufficient physical and mental exercise in the day and be less active before you go to bed so that you do so more relaxed. Make sure you are adequately full and have a regular bedtime. Try to go to bed happy and comfortable without any disturbances such as external noise.
    • If your bad mood is due to illness then try to get well. When this is not possible endeavour to blame your illness rather than other people. For those whose bad mood is caused by depression see ‘Overcoming Depression’ in the Forward Counselling Advice Service.
    • Reduce the effects of stress on your life by: Examining the pressures you are under and removing one or two of these stresses; Learning to deal with the stresses more effectively – identify your stresses and ask others how they cope with those stresses then make a plan of action and implement it; Viewing your stresses in a different way and acting on this new view.
    • Nurture and consolidate your intimate, work and outside of work and intimacy relationships (e.g. friends and neighbours). Beware of distributing disturbances in one area to the other two areas.
      

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13. Anger Management
    • You need to learn to deal with your anger effectively rather than suppressing it or being enraged.
      1. Keep Notes About Your Anger
         • When and why you are angry; your thoughts and behaviour when angry; rate how strong your anger is using the scale 0-10, (0 is irritated, 10 is enraged).
         • Make honest, daily anger notes for a fortnight or more, dating each entry – this will enable you to see what things need to be improved.
         • Answer the following questions in your notebook:
           1. How frequently do I get angry?
           2. Do others know when I am angry?
           3. Does my anger help me to cope?
           4. Is my anger preventing recovery?
           5. What do I achieve from being angry?
           6. Can I obtain these things in other ways?
           7. Do I express anger in ways others expressed anger in my childhood or differently?
           8. Do I feel relief from getting angry?
           9. Are there alternatives to getting angry yet achieving the same sense of relief?
           10. Could I consider forgiveness as opposed to revenge or a compromise between the two?
      2. Dealing With Bodily Sensations:
         • Consider the physical sensations that tell you that you are becoming angry e.g. do you become tense and sweat?
         • Control your physical sensations due to anger, by using the Controlled Breathing and Relaxation techniques:
         • As well as the above techniques you could try healthy physical exertion e.g. taking a vigorous walk.
      3. Specific Anger Management Techniques:
         • The ‘Time-out’ technique:
           • Discuss with your partner and others concerned beforehand that as part of learning to control your anger, you will take a ‘Time-out’ next time you are angry.
           • This means that you will leave to be alone for no more or less than an hour, when you feel your anger rising.
           • During this time you should not drink or drive. Use any technique that will help you to calm down and not over react when you return e.g. controlled breathing or physical exertion.
           • Explain to those concerned that you are not rejecting them nor should they worry about you when you need to be alone to calm down.
           • Request their support in your efforts at anger management.
         • The ‘Thermometer’ technique:
           • Visualize a large thermometer with red mercury to represent your temper. Allow yourself to see the graduation marks.
           • When you are calm there is just enough mercury for effective interaction with others. As you become agitated the temperature will rise – you will be aware of bodily sensations such as quickened breathing and flaring nostrils.
           • All thermometers have marks at the top for a ‘danger zone’ and you need to bring the mercury down before you get into this zone where you will lose control over your thinking so will be unable to act appropriately.
           • Use controlled breathing or the ‘time-out’ technique or any other means to get the mercury to fall to a safe level where you are in control of your anger.
           • When you reach room temperature level you can deal with the situation in a rational manner.
           • You will need to use this technique regularly for effective results.
         • The ‘Assertive Communication’ technique:
           • Clarify what you want to discuss that is upsetting you.
           • Communicate your feelings using ‘I’ statements e.g. ‘I am frustrated…’
           • Specify the action you want to happen.
           • State any stipulations or consequences.
           • Thank the other person for listening.
           • Try rehearsing the ‘Assertive Communication’ technique before an encounter.
    • If you are doing yourself physical damage e.g. cutting or self-mutilating, you are not coping and should seek the help of a professional.

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14. Graded Exposure

    Dealing With Problem Behaviour – Avoidance: Graded Exposure

    • To overcome your fear you need to face it at your own pace. Identify and write down an accurate description of your fear. Deal with one fear at a time.
    • 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 rather than avoiding it. There are three stages:
      
      
      1. Setting targets – Your descriptions of fears such as objects and situations that cause avoidance and anxiety needs to be arranged in order of difficulty with the easiest first. These are your targets.
      2. 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 shop at the supermarket, alone – you could start by shopping for one item at the local shop with the correct money then with a credit card then buy several items with a credit card. Next you could try graded steps at a local store followed by a mini-market and finally at a supermarket.
      3. Practicing – 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). Write down any other related details.
      

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15. Problem-Solving

    Dealing with Problem Behaviour – Problem-Solving

    • Sometimes there is no time to follow a graded approach – the problem-solving approach can be useful in these cases. You learn to focus your thinking and find solutions to your problem instead of panicking. There are six steps in problem-solving:
      
      
      1. Define the Problem – Be specific and try to break the problem into more manageable tasks. Do one task at a time. Choose your task and specify your goal.
      2. List Solutions – Try to write down as many ideas, to solve your problem, as you can.
      3. Evaluate the Pros and Cons of Each Solution – Consider your solutions and reject the unsuitable ones. List the remaining solutions in order of usefulness.
      4. Selecting a Solution and Planning 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.
      5. Do it - Attempt your solution.
      6. Review the Result of the Solution – If your solution is successful try to understand why it was so. If your solution is unsuccessful try to comprehend why it did not work. Praise yourself for having tried and choose your next solution from your list.

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16. Managing Your Time
    • Good time management requires being aware of:
      1. Your needs and strengths - list these opposite each other.
      2. 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.
      3. 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?
      4. Setting reasonable goals - keep in mind the important areas of your life when pursuing goals. Clearly define your goals so you know when 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.
    • Delegating - giving over responsibility with authority, to others for appropriate tasks, is part of good time management.

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17. 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.
    • Sleep is affected by mood, stress, food, alcohol, exercise and medicines.
    • 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 if 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 very 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:
      1. 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.
      2. Introduce pleasant smells into your sleeping environment to help you relax e.g. potpourri or lavender oil.
      3. 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 and 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 and a comfortable bed and have emptied your bladder before trying to sleep. Use your bed only for sleeping and set an alarm so you wake regularly each day. Avoid naps during the day.
      4. If you sleepwalk you are advised to discuss this with your doctor as it can be dangerous.
    • To cope with disturbing dreams you could try:
      1. Constructing a positive ending to your disturbing dream and mentally practicing this alternative ending several times before sleeping;
      2. Practicing beforehand what you might say if the dream occurs;
      3. Keep water and a towel by your bedside to wash your face with if you wake up sweating - this will help you re-orientate;
      4. 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:
      1. Ensure you have some time to yourself and push your worries to one side;
      2. Sit or lie comfortably and close your eyes with your arms by your side;
      3. Concentrate on breathing naturally;
      4. Place your hands on your stomach and 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;
      5. 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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18. Conclusion
    • You may encounter difficulty in giving up old habits for new ones.
    • Before you allow yourself to be distracted from practicing your new habits, weigh the pros and cons and make a responsible decision for when and where you will next do the exercise.
    • 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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