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Comment on Exam preparatory skit

Sue B. — Tue, 27 Jul 2010 05:06:56 GMT

1) All worthwhile frameworks, models, or processes ultimately help clients ask and answer for themselves what four fundamental questions according to one of our authors, Gerald Egan (pg. 70, The Skilled Helper)?

The first question it helps our clients ask themselves is what's going on? This is what Egan calls the client's current picture or what the clients is seeing you for. The second question is what do I need or want? This is what Egan calls the client's preferred picture or what they want to accomplish from therapy. The third question is how do I get there? Egan refers to this as the plan or how the client will achieve the goals set from question two. The fourth question is how do I make it all happen? Egan refers to the action arrow to indicate broad and specific actions clients must take in order to produce the changes they want. This is what the client actually does in order to accomplish their goals.

2) According to Judith Beck, when would a beginning cognitive therapist be advised to use alternative questioning (pg 116, Cognitive Therapy: the Basics and Beyond)?

"The beginning cognitive therapist is advised to use Figure 8.1 as a guide when initially evaluating automatic thoughts". Beginning cognitive therapists are encouraged to use alternative questioning when he/she judges that the standard questions will be ineffective. An example is when a therapist varies the questioning to help the patient adopt a more functional perspective.

3) Expand more on what Alex Wolf was saying pertaining to Alfred Alder and birth order/family genograms. Based off of what you already know about Alder's theory on birth order, explain in your own words and opinion what effect being the middle child may have on a person.

Being the middle child has the potential to cause a lot of different issues for the child based on his or her different experiences growing up and how their parents and the rest of their family treat them. They may often feel caught in the middle or unloved because they are not the first or the beloved baby of the family. They may feel pressure to live up to the demands made on them because of their older sibling; like they have to live up to the expectations that their older sibling set. Or they may feel like they are being punished for all of the mistakes that their older sibling did.

Comment on Exam preparatory skit

Patti Skinner Sulpizio — Mon, 26 Jul 2010 22:43:41 GMT

Note; I can't figure out how to "bold" the answers so the correct answer is supplied after each question.
Choose the best answer to the following questions

1. Goal(s)of session bridging
A. Supply agenda items for future sessions
B. Motivate client to think about therapy during the week
C. Elicit patient feedback not offered previously
D. Learn topics bothering client
E. Bring up content client doesn't mention or recall
F. Encourage client to write down important points
G. All of the above

Correct answer is G.

2. Egan’s three dimensions of responding with empathy
A. Preconceived notions, know-it-all attitude and attacking misconceptions B. Perceptiveness, know-how and assertiveness
C. Pleasantness, knack and anal retentive behavior
D. Perfection, kinesis and aggression

Correct answer is B

3. According to Judith Beck, the steps in therapy are
A. Free association, analyze dreams, facilitate corrective emotional experience
B. Establish therapeutic alliance, treat client with unconditional positive regard, synchronize client’s idealized and actual self
C. identify automatic thoughts, evaluate and respond to automatic thoughts, do problem solving if thoughts are true
D. recognize individual in context, notice enmeshment and disengagement,
prescribe the symptom

Correct answer is C.

Comment on Exam preparatory skit

Christine Waldron — Sun, 25 Jul 2010 22:58:29 GMT

1. What is meant by the term “early narcissistic wounds” used by Gerard Eagan?
“Narcissistic wounds are those emotional problems which occur as a result of the fact that a parent failed to meet the child's emotional needs when he or she was growing up. This leads to a sense of emotional insecurity which is marked primarily by a feeling of emptiness or a lack of feeling an emotional connection. The main hallmark of the narcissistic wound as compared with other emotional deprivation in childhood is that the parent may have given attention to the child only when the child was "performing" to satisfaction. In other words, the child was used to feed the narcissistic ego of the parent” (quote from Identifying and Healing Narcissistic Wounds 92 By Kathryn Vercillo http://hubpages.com/hub/Identifying-and-Healing-Narcissistic-Wounds).
2. Who was James F.T. Bugental, the Existential Humanist?
James Bugental, Ph.D., A.B.P.P., Professor Emeritus, International Institute for Humanistic Studies, died age 92, September 18, 2008. Former professor of psychology at University of California at Los Angeles, Georgia Tech University, Saybrook, Emeritus Clinical Faculty at Stanford University School of Medicine, and a Rockefeller Scholar at the California Institute of Integral Studies. He was the first President of Association of Humanistic Psychology, Division 32 of American Psychology Association. First recipient of Rollo May Award, author of over 60 articles and chapters on Existential-Humanistic psychology and psychotherapy, and author of seven books beginning with Search for Authenticity and most recent, Psychotherapy Isn't What You Think. Other books include: Psychotherapy and Process, Intimate Journeys, The Art of Psychotherapy and editor of two versions of the Handbook of Humanistic Psychology. His books have been translated into many languages and used widely in undergraduate and graduate schools of psychology and psychotherapy. (Information obtained from: The International Institute for Humanistic Studies (I.I.H.S.) http://www.human-studies.com/jim-bugental.php)
2. What is meant by the term “session bridging?”
Session bridging is a term coined by Judith Beck which refers to the use of a session bridging worksheet. This is done to assist a patient in remembering the content from a previous session. Beck writes that “asking for reactions to the past session made illicit important feedback that the patient can not previously offered.” Her book also states that “this bridge from the last session helps to socialize the patient into the therapeutic process, giving her the message that she is responsible for reviewing the content of each session and for telling the therapist whether she was bothered by anything about the therapist or the previous session” (Beck, 1995, p.p.49-50).

Comment on Exam preparatory skit

Carol McCabe — Sat, 24 Jul 2010 15:49:52 GMT

1. THE PURPOSE OF “BRIDGING” A SESSION IN CBT IS FOR:
a. CHECKING ON THE PATIENT’S PERCEPTION AND UNDERSTANDING OF THE PREVIOUS SESSION
b. HELPING TO SOCIALIZE THE PATIENT TO THE THERAPEUTIC PROCESS
c. GIVING PATIENTS THE MESSAGE THAT THEY ARE RESPONSIBLE FOR REVIEWING THE CONTENT OF EACH SESSION
d. TEACHING PATIENTS THAT THEY HAVE THE RESPONSIBILITY OF INFORMING THE THERAPIST IF THEY BECOME BOTHERED BY THE THERAPIST OR PREVIOUS SESSION
e. ALL THE ABOVE
Answer: (e) – all the above

2. ACCORDING TO GERARD EGAN, THE ACRONYM “SOLER” IS USED TO SUMMARIZE NON-VERBAL COMMUNICATION SKILLS. THE “R” STANDS FOR:
a. REAL
b. READY
c. RELAXED
d. RELATIONAL
Answer: (c) Relaxed

3. ALFRED ADLER SUGGESTS THAT PERSONALITY DEVELOPMENT IS INFLUENCED BY FAMILY FACTORS INCLUDING:
a. BIRTH ORDER
b. BEHAVIOR MODELED BY PARENTS
c. FAMILY VALUES
d. FAMILY ATMOSPHERE
e. HOW A CHILD’S ROLE IN THE FAMILY IS ESTABLISHED
f. ALL THE ABOVE
Answer: (f) all the above

Comment on Exam preparatory skit

Mark C. Pfost — Sat, 24 Jul 2010 03:57:17 GMT

I. QUESTION:
As opposed to the allegation on the part of Wolf which seems to imply that CBT views thoughts and emotions as unrelated,
(“You talk about distinguishing automatic thoughts from emotions on page 95, but how can you simply compartmentalize different realms of human existential experience like that. Our thoughts and emotions cannot be studied independent from one another.”)
Describe how CBT speaks to the interrelatedness of thoughts (for instance, automatic thoughts. ... hello ) and emotions.
Answer:
In a specific situation, one’s underlying beliefs influence one’s perception, which is expressed by situation-specific automatic thoughts. These thoughts, in turn, influence one’s emotions.
(CBT and Beyond, p. 17)

II. QUESTION:
The “SOLER” scenario presented by Egan in The Skilled Helper is intended to present evidence of what helper behavior to clients, and why is that evidenced quality relevant to the therapeutic relationship?
Answer:
“SOLER” principles reflect being “visibly tuned in to clients.” (p. 134)
This is relevant to the therapeutic relationship because “clients read cues in your nonverbal behavior that indicate the quality of your presence to them. Attentive presence can invite or encourage them to trust you, open up, and explore the significant dimensions of their problem situations.” (p. 133)

III. QUESTION:
In what manner might relevance of past personal history of the client manifest in CBT?
Answer:
Two examples of such considerations are presented (CBT and Beyond) as follows: historical tests of a core belief which serves to examine how a belief originated (p. 183) and the restructuring of early memories (p. 184) which can serve to assist the client to reinterpret and potentially defuse earlier traumatic experience.

Comment on Charly: Movie PSYCHOanalysis

Deficit History — Thu, 08 Jul 2010 06:30:48 GMT

Fascinating read. Very interesting! This one is really an attractive piece……..worth to be chosen for the hot content list………………keep it up……

Comment on The Bottle's Gettin' Bigger: The Sad, Short life of Hank Williams

Sue B. — Tue, 29 Jun 2010 21:00:25 GMT

The song relates to the story of Hank William's life in that both of the people had problems with alcohol and let alcohol control their lives. Both men knew alcohol was their "enemy", but neither was able to win their fight against it. As other's have said, the song mirrored Hank's life.

A possible core belief of Hank's is that he does not think he is capable of accomplishing anything on his own. This is shown by him needing his mother and wife to push him into becoming a successful musician and by him depending on alcohol in order for him to come up with songs and be able to deal with life stressors.

I think an intermediate belief of Hank's is that of never being good enough. That belief is shown when he expresses the belief that he will only be someone if he can make it to the "Grand 'ol Opry". All his other accomplishments weren't good enough unless he could make it there. It's also possible that he did not think he was good enough to keep Audrey.

Possible automatic thoughts of a deleterious nature are that of "I will never be successful", "I will never be good enough", and "I can’t do it on my own".

Early intervention could have kept Hank from becoming a renowned musician. If he was able to overcome his self esteem issues he may not have been able to be as creative because he didn't have a reason to. He may have still been a good musician, but I think his songs would lack depth because he would not have as many life experiences he could draw from.

Comment on Ordinary People, extraordinary psychiatrist and Mrs. Pain

Alicia Dukoff — Tue, 29 Jun 2010 04:17:26 GMT

1. A CBT therapist would identify a problem, or a set of problems and set out to acheive goals to help these problems with the client themselves. In the movie, Dr. Berger did not do this with Conrad but rather, allowed a free-flowing stream of consciousness to develop in each session as Conrad became more in-tune with his feelings. iT was a slow process, but one which u;timately benefitted the charactor of Conrad becasue he was not instatly aware of his deep-rooted issues and it would not have served him well to try to identify these problems right away. Therefore, a CBT therpaists' mission to set goals would not have been able to be fully acheived either. The approach used in the film was the best way to conduct therapy with Conrad.

Conrad's mother was like Mrs. Pain in the way that both women are stuggling with pain, nut MORE SO HOW to deal with that pain. If one doesn't handle the pain and try to place it in a better and more healing light, then it will grow and develop into a monster that affects lives in disasterous and sneaky ways. Sneaky becasue suppression is the fastest way to make something grow- it will fester queitly in the depths of your soul until one day, a small and seemingly insignificant and unrelated event will occur and the person will completely go to pieces, revealing the layers of suppressed and festered pain, anger and sorrow that has had a chance to accumulate in the depths below.

Conrad is suffering from PTSD after the death of his brother and I think he should be treated primarily for that purpose. All feelings of depression, guilt, shame and removal of one's self from family and friends are all clear signs of the presence of this disorder. The subsequent feelings of anger, frustration at not understanding himself or feeling misunderstood and alone in relation to everyone around him is also clearly in result of him suffering a great deal of grief and sorrow for the loss of his brother that he hasn't fully and properly allowed to heal and release. He has kept it bottled up and needs to release his pain, before he becomes tight and twisted like his mother, the greatest antagonist of the film, because she was the figure who was most suppressed and wouldn't deal with her emotions, not allowing anyone else's to be set free either.

Comment on The Bottle's Gettin' Bigger: The Sad, Short life of Hank Williams

Alicia Dukoff — Tue, 29 Jun 2010 04:04:35 GMT

1. The song relates to Hank Williams' life in the sense that alcohol became an increasingly large and destructive entity in Hank's life. The phrase "The bottle's Gettin' Bigger'" is a metaphor in this case being that the bottle of liquor gradually became more and more present and he became more and more dependent on it as he passed through the years of his life. By the end of his days, he had succumb to the bottle and the negative effects his drinking had developed in his life.
2. A) Hank Williams seemed to have suffered from problems of self worth. He may have been fighting against his worst enemy, which was himself, constantly hearing statements of "unlovable" in his head that fed his own inner turmoil even more. Overall feelings of worthlessness and inferiority seemed like definite core beliefs of this man on many levels and this is what ultimately led him to drink more, as he tried desperately to drown them out.
2. B) Hank's intermediate beliefs were the subsequent manifestation of his core beliefs. Because he already feels unworthy and unlovable and inferior and "not good enough", he then subconsciously translates these beliefs into intermediate ones such as "If I drink, i can feel less pain" or "If I abuse myself, it's what i deserve anyway".
2. C) An Automatic thought of Hank's might be "When I am drunk, I am most inspired and free". Another might be "I can really be myself after I've had a drink and this helps me play my music from the heart, which is what helps people because they relate to my pain."
3. I am a firm believer that if you are born a musician, it is in your blood, in your heart and in your soul. There are young children who arrive on the scene with a spark and a story to tell and no one knows where it ever comes from. It is either inside of you or it isn't. That kind of ability to connect millions of people through the music that comes from your soul is a gift from God- it can't be taught and it CANT be stopped- I don't care how much therapy someone has.

Comment on The Bottle's Gettin' Bigger: The Sad, Short life of Hank Williams

Patti Skinner Sulpizio — Tue, 29 Jun 2010 00:39:26 GMT

1) The song mirrors Hiram “Hank” Williams’ struggle. The lyric,"I'm shrinking every minute, but my mind don't seem to get it," parallels what Roy Acuff said. "You've got a million dollar voice but a 10 cent brain". Hank succumbs repeatedly as his "bottle keeps growing". Despite incredible talent, huge success, well intentioned advice and interventions of family and friends, Hank Williams' alcoholism seems hopeless, progressive and irreversible.
2)As we develop a therapeutic alliance, Hank tells his story. I use it to reveal dysfunctional beliefs.
a) Together, we agree, his father's 8 year absence and mother's habit of leaving him to fend for himself contributes to core beliefs, "I'm unlovable. I'll always be alone."
b) An intermediate belief,” I will harm myself and others," arose from his family nickname, "Harm". The situation, constant pain from his spina bifida and subsequent injuries; his reaction; using drugs and alcohol to sooth himself, result in professional and relationship failures, proving his harm theme, further cementing core beliefs, “I’ll always be alone. I’m unlovable.”
The intermediate belief, "I’m a product", is prompted by being used and controlled by his mother, wife, agents, promoters and record companies.
c) Hank’s belief, harm is my destiny, motivates deleterious automatic thoughts justifying drinking and self medicating. The situation, of being taken advantage of, seals his belief, “I’m a product”, inspiring the automatic thought, “rebel”, prompting more drinking, irresponsible behavior and self sabotage.
3)In CBT I ask Hank to bring his music to explore the metaphors within. Since Hank claims he prefers to be appreciated more as a song writer than performer, I suggest HE choose to bring his guitar or only lyrics. My goal is for Hank to see that as much as is humanly possible, he’s in control of his destiny.
Together we attack his core beliefs. Hank realizes his father’s absence is due to illness, not lack of love. We re frame constant fights with Audrey as proof of their passion. “Your Cheating Heart”, oft thought to be about Audrey, and “I Heard My Mother Praying For Me” show his conflicted feelings. Mom said Dad died, which drove Dad away a second time. She took wages from him and the band, but he still wants to please her. Asking him to reflect how songs like, “I’m So Lonesome I Could Cry “ inspire audiences to cry, swoon and give 6 encores, he recognizes he's touched the universal human theme, "I am really alone” enabling him to feel their abundant love. I point out,“Harm” may be just a lazy southern way of saying “Hiram”. He sees it will be his own “Cold Cold Heart” if he dies from drinking. Sober, he's his own product; rights to his music and new redemption songs. Anticipating the decline of hillbilly style to crossover country pop music, before his songwriting and performing career dumps, he crafts a successful career producing and promoting other artists, returning to therapy as needed to prevent relapse.