|Sponsored by the HealthcareTrainingInstitute.org providing Quality Education since 1979|
Effectively Treating Pathological Self-Criticism in Depressed & Dysthymic Clients
On the last track we discussed self-degradation ceremonies and the three common consequences of those ceremonies. The three common consequences of self-degradation ceremonies were Behavioral Restriction, Emotional Distress, and an Inability to be the Final Arbiter of One’s Own Status.
On this track we will discuss the differences between destructive self-degradation and constructive recognition of personal limits.
Obviously, not every instance of self-criticism that results in the appraisal of diminished status and eligibility is problematic. For example, if an alcoholic has been negatively affecting his family for years through his heavy drinking, sobering up may cause him to come to the conclusion that his alcoholism caused him to be selfish for many years. He may then realize that his selfishness hurt his family.
Rachelle, age 22, a sophomore in college, had for years called herself "intellectually dull." Growing up, she was the youngest in her family by two years and as a result was always a little behind everyone else. Her family treated her as a cute, amusing, and slightly dim-witted baby of the family, and Rachelle herself adopted this view, which contributed to her depression and the belief that she was not as "good" as everyone else. Although she graduated from a competitive high school with a 3.5 GPA and was carrying the same GPA at her college as she began therapy, she maintained that she was not very smart.
I have found that there are generally three criteria for distinguishing between constructive recognition of personal limits and destructive self-degradation. As I list the criteria and explain how they applied to Rachelle, think of your depressed or dysthymic client. How much of his or her self-criticism is constructive recognition of personal limits? How much is destructive self-degradation?
Three Criteria for Recognizing Self-Degradation
Technique: Destructive Judgment Journal
I have found some clients react well to being provided with the facts of their disorder. Would it be beneficial to play this track or other tracks in this CD set for a client of yours?
Do you have a depressed or dysthymic client that makes self-criticizing comments? Based on the three criteria, is this self-criticism constructive recognition of personal limits, or is it destructive self-degradation? If it is the latter, would the "Destructive Judgment Journal" be an appropriate exercise for your client to try? Would you consider replaying this track in your next session?
On this track we have discussed recognizing the difference between destructive self-degradation and constructive recognition of personal limits. We have discussed three criteria for determining if self-criticism is destructive self-degradation or not. These three criteria were realism versus lack of realism, wider implications of worth, and degree of self-punitiveness present.
On the next track, we will discuss the four perfectionist standards which depressed or dysthymic clients who self-criticize may use. These four standards were "Being Number One," "Being God," "Better Way," and "Ceaseless Productivity."
Peer-Reviewed Journal Article References:
Monroe, S. M., Anderson, S. F., & Harkness, K. L. (2019). Life stress and major depression: The mysteries of recurrences. Psychological Review, 126(6), 791–816.
Peterson, K. M., & Smith, D. A. (2010). To what does perceived criticism refer? Constructive, destructive, and general criticism. Journal of Family Psychology, 24(1), 97–100.
Tangney, J. P., Wagner, P. E., Hill-Barlow, D., Marschall, D. E., & Gramzow, R. (1996). Relation of shame and guilt to constructive versus destructive responses to anger across the lifespan. Journal of Personality and Social Psychology, 70(4), 797–809.
Online Continuing Education QUESTION 3
Others who bought this Depression Course