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Effectively Treating Pathological Self-Criticism in Depressed & Dysthymic Clients
Effectively Treating Pathological Self-Criticism in Depressed and Dysthymic Clients

Section 14
Track #14 - Helping Clients Learn to 'Let it Slide' with the 'Nasty Thermostat'

CEU Question 14 | CEU Answer Booklet | Table of Contents
Counselor CEUs, Psychologist CEs, Social Worker CEUs, MFT CEUs, Nurse CEUs

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On the last track, we discussed three principles behind this method of non-resistant change in regards to self-critical depressive clients.  These three principles behind the method of non-resistant change included:  position of control; neutralization of unhelpful self-coercion; and the dynamics of ambivalence.

On this track, we will examine three image techniques to help self-critical clients become more receptive to constructive criticism.  These three image techniques to help self-critical clients become more receptive to constructive criticism include: parent; boss; and nasty thermostat.

Share on Facebook Three Criteria for Role-Playing Activities
To begin, I find that it is important that the self-critical client meet three criteria prior to the role-playing activities. 

First, the client should possess a good understanding of the role captured, and, most importantly, a good understanding of what competent and constructive enactment of that role would look like.  If he or she does not have a sufficient grasp of these matters, my illustrations and appeals may serve only to leave the client confused. 

Second is that the client should value the role and the whole way of behaving that it captures.  The client, for example, who values what good coaches do for their athletes will appreciate the worth that inheres in constructively fulfilling the critic functions that are part of that role. 

And third, is that clients should show some resonance to its use.  I consider whether the client is captivated by the image or at least hold the client’s interest?  If the image does not accomplish at least holding the client’s attention, I decide to abandon it.

3 Image Techniques to Increase Reception of Constructive Criticism

Share on Facebook Technique # 1. Parent
The first technique to help self-critical clients become more receptive to constructive criticism is playing the parent role.  What is central to this role is parental love—a personal care and commitment to the best interests of one’s child, understood as a commitment to doing one’s best to enable that child to become a competent and meaningful adult. 

One of the main responsibilities of parenthood, in addition to guidance and support, is the need for parents to function as critics of their children.  In this role of critic, their first major job centers around recognizing and appreciating what is positive and functional in their children. 

The second major job of parents as critics is that of identifying and of attempting to help their children to alter behaviors and characteristics that are problematic.  I ask my clients to view a wide variety of destructive things that they do to themselves through the perspective of a parent criticizing his or her child.  Would they systematically focus on negatives and never appreciate the positives with their own hypothetical or actual children?

Wendy, age 48, had been berating herself for losing her temper at one of her coworkers the other day.  Wendy stated, “I shouldn’t have yelled at him like that!  I’m such a hothead, and I’ll never be able to control this anger!  I will never get my promotion because no one wants a woman who can’t control her emotions!” 

I stated to Wendy, “I would like for you to picture your daughter, not you, sitting in this empty chair right here, and she has made that mistake, not you.  Now, you truly believe that what you have done is a serious mistake.  You don’t want to let it slide.  You want to help her to correct it.  Why don’t you speak to her as a mother.  What would you say to her to deal with this matter?” 

Wendy stated, “I guess I would say, ‘We talked about this before.  It’s wrong to lose your temper and yell at other people.  They don’t do what you want them to anyway because they are too angry.  Instead, you should count to ten the next time you get angry.  Because you lost your temper, I’m going to give you five minutes time out.’”

I then asked Wendy if she thought this was an appropriate punishment for an angry child.  She stated, “Yea, that’s what I give my nieces and nephews and they usually respond.”  I then stated, “Do you see the disparity between the punishment you gave the child and the unending punishment you gave yourself?  Instead of berating yourself nonstop, I want you to try and criticize yourself the way you just criticized your daughter.” 

Think of your Wendy.  Would he or she benefit from fulfilling the role of a parent?

Share on Facebook Technique # 2. Boss
The second technique to help self-critical clients become more receptive to constructive criticism is playing the role of the boss.  The same concepts as those applied to the parent role may be employed for the role of a supportive boss who wishes the best for his or her employees.  I have found that destructive critics who tend to benefit most from the boss image are perfectionistic individuals who drive themselves relentlessly for achievement and productivity.

Clients who take on the image of the boss should be able to define Exceptional Leadership as that one:
a. Sets high but reachable standards
b. Gives explicit recognition for worker efforts and accomplishments
c. Considers employees’ ideas, needs, and feelings and
d. Employs modes of correction that are firm and clear without being overly degrading. 

Molly, age 39, was known as a rather effective and supportive supervisor in her agency.  However, although she could constructively criticize and support her own employees, Molly could not let herself commit mistakes without severe and drastic consequences. 

I asked Molly, “Would you drive your supervisees relentlessly from morning to night the way that you do yourself?  Would you pressure them to make every minute productive and criticize them of being lazy if they took a little break or wanted a night out with their families?  How would you expect them to respond if you did so?  Would you expect more productivity?” 

Molly stated, “No!  I would expect them to quit!  And then I would have quite a mess on my hands, and then I would be fired!  If anyone treated my employees like that, I would fire them immediately.”  I stated, “Well, what we are trying to accomplish here is to get you to fire your self-destructive inner critic and replace it with a more supportive and effective supervisor.” 

Think of your Molly.  Is he or she a perfectionist?

Share on Facebook Technique # 3. The Nasty Thermostat
In addition to the roles of the parent and the boss, the third technique to help self-critical clients become more receptive to constructive criticism is the nasty thermostat.  Rarely, some highly self-critical clients cannot benefit from the employment of social role concepts such as “parent” or “boss.” 

While they might possess them in a rudimentary way, their relational lives have been so impoverished that they do not know in any full sense what a parent or friend is and are often cynical about such notions.  For such clients, one option I employ is that of using images and metaphors from the world of mechanical systems.

Lou, age 46, had been ostracized from his family and other friends.  As such, Lou had little concept of a supportive family or really, any other supportive relationship.  Instead, he became cynical at the thought of a non-destructive parent. 

He stated, “But parents don’t do that for their kids.  It’s a bunch of ‘Leave it to Beaver’ bullshit that the media feeds us and too many families digest.”  Instead, I stated to Lou the concept of the Nasty Thermostat.  I stated, “Think of your thermostat that you have at home.  Part of it’s job is to recognize when the temperature in your house is within a certain desirable range.  When the temperature is in that range, it leaves well enough alone. 

However, when it gets too cold or too hot, its job is to recognize that things are outside of the desirable range and to do something about it.  However, think of this image of a “nasty thermostat.” 

When it detects that the house has gotten too hot, it just yells down to the furnace, ‘You are a really crappy furnace’ and goes on to berate the furnace roundly.  I doesn’t do anything else, such as turn the furnace off—it just puts it down.  In a way, that’s what you’re doing.  The whole point of you functioning as a critic is to recognize when things are going right and to leave them alone, and to recognize when they are going wrong and to figure out what’s wrong and do something to correct yourself.” 

Think of your Lou.  Would he or she be more receptive to the image of the “nasty thermostat”?

On this track, we discussed three image techniques to help self-critical clients become more receptive to constructive criticism.  These three image techniques to help self-critical clients become more receptive to constructive criticism include: parent; boss; and nasty thermostat.

Online Continuing Education QUESTION 14
What are three image techniques to help self-critical clients become more receptive to constructive criticism? To select and enter your answer go to CEU Answer Booklet.


This CD set has covered such topics as:   consequences of self-criticism; self-degradation ceremonies; recognizing self-degradation; perfectionist standards; consequences of perfectionism; the hanging judge; eternal penance; assessing ownership; self-critical goals; resistances; minimizing resistance; situational triggers; change principles; and constructively criticizing.

I hope you have found the information to be both practical and beneficial. We appreciate that you've chosen the Healthcare Training Institute as a means for receiving your continuing education credit.

Other Home Study Courses we offer include: Treating Teen Self Mutilation; Treating Post Holiday Let-Down and Depression; Living with Secrets: Treating Childhood Sexual Trauma; Interventions for Anxiety Disorders with Children and Adults; and Balancing the Power Dynamic in the Therapeutic Relationship. 

I wish you the best of luck in your practice. Thank you.  Please consider us for future home study needs.

 
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Effectively Treating Pathological Self-Criticism in Depressed and Dysthymic Clients

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