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On the last track we discussed a guide to assessment. This guide covered five areas of assessment. These five areas are pathological practices, ownership of self-critical behaviors, the client’s purposes, problematic situations, and historical influences.
On this track we will discuss cognitive restructuring to raise self esteem. Three Cognitive Behavior Therapy methods for cognitive restructuring for self esteem are self reproach evaluations, personifying the critic, and introducing the healthy voice. I find that the best place to begin is with the client’s thoughts.
Method #1: Self Reproach Evaluations
With your client, like Chad, you can get as much detail as you can about the critical self talk and then introduce the concept of the pathological critic. We’ll discuss the pathological critic and how to disarm the critic in more detail on later tracks. First, however, would you agree that evaluating your client’s degree and method of self reproach can be a productive way to begin cognitive restructuring for self esteem?
Method #2: Personifying the Critic
Chad named his pathological critic ‘the shark,’ because Chad felt the critic was underhanded. In later sessions with Chad, he seemed to feel that it was easier to fight against self reproach once he perceived it as something external. I find that with clients like Chad, the belief that the voice of criticism is not the client’s own can be productive. In short, cognitive restructuring for self esteem becomes easier when the therapist makes the critical voice ego dysotonic, or something the client eventually rejects as ‘not me.’
Method #3: Introducing the Healthy Voice
Would you agree that by creating this dichotomy between the critical voice and the healthy voice, you can encourage clients to confront the critic. For example, I asked Chad about a new friend that he had made. I asked, "So what did the critic say when you waited and didn’t hear from your new friend?" Chad responded, "That I’m not interesting, that I bored him and he was tired of me." I then asked Chad what the healthy coach said back. Chad stated, "That our conversation was lively and fun. That there was nice energy between us. I could also call my friend and try to get a sense of how he feels."
On this track we have discussed CBT methods for cognitive restructuring for self esteem. Three methods we discussed were self reproach evaluations, personifying the critic, and introducing the healthy voice.
On the next track we will discuss the pathological critic. I find that these critics begin with an arsenal of shoulds which can be linked to five determining factors of the strength of the self critic. These five factors are the degree to which issues of taste, personal needs, safety, or good judgment were mislabeled as moral imperatives, the degree to which parents failed to differentiate between behavior and identity, the frequency of the forbidding gestures, the consistency of forbidding gestures, and the frequency with which forbidding gestures were tied to parental anger or withdrawal.
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