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Section 7
Dessensitization and Cognitive Restructuring

Question 7 | Test | Table of Contents

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In the last section, we discussed probing.  We discussed key words, a list of don’ts and techniques for probing the nagger.

In this section, we will begin a three part discussion on obstacles to change.  In the face of so much pain and so many destructive consequences, pathological self critical practices seem to accompany past abuses frequently. Would you agree that there are many obstacles to clients overcoming low self-esteem?  I find that by examining these obstacles, clients can begin to understand the difficulties they may face in attempts to change and break away from the victim mentality of being abused. 

The next three sections, will each discuss one specific category of obstacle accompanied by a cognitive behavior threrapy technique to help your client overcome that type of obstacle.  However, you might find the techniques to be interchangeable and, therefore, not limited to a specific category. 

In this section, we will discuss obstacles to change manifested as habit and reflex.  The accompanying technique is called The Howitzer Mantras.  As you read this section, you might consider your client.  Could he or she benefit from listening to how Joan used the howitzer mantra to overcome habit and reflex as an obstacle to change?

♦ Obstacles to Change: Habit and Reflex
Clients like Joan engage in destructively self critical acts in such a habitual, reflexive way that they cannot observe what they are doing to themselves.  For example, Joan, age 41, had self appraised that her quietness at parties was further evidence that she was a complete social incompetent with nothing of interest to say to others. 

However, Joan did not make this statement herself.  The only clues to be found that such a verdict had been rendered were feelings of depression, inferiority, and personal insufficiency experienced by Joan during and after the party.  Thus when instantaneous destructive self appraisals have been made, it may be difficult for the client to observe and recognize their precise nature and, consequently, to report this in psychotherapy. 

♦ CBT Technique:  The Howitzer Mantras
To help Joan overcome the habit of self criticism which had become her lifestyle, I introduced her to the idea of the howitzer mantras.  The way I implemented this technique with Joan allowed her to replace her habit of self criticism with her chosen mantra.  I stated to Joan, "These are selected words or phrases that are designed to hit the critic like a cannon blast." 

Some of the mantras Joan and I reviewed were, "This is poison.  Stop it!," "These are lies my father told me," "Stop this shit!."  "Shut up!,"  "Screw you!,"  "Get off my back!,"  and, "Stop this garbage!"  I stated to Joan, "Choose a mantra that helps you feel angry.  This is a technique in which getting mad at first can be productive.  You might even find that profanity can be a productive response to the critic.  When you use these ‘howitzer mantras,’ shout them inside.  Mentally scream them at your critic so that you can drown it out with your anger and indignation." 

At a later session, Joan stated, "My critic continues to beat me down despite those howitzer mantras.  I don’t know what to do."  How might you have responded to Joan?  I stated, "Maybe it’s time for stronger measures.  You might consider putting a rubber band around your wrist and snap it while subvocalizing your mantra."  For example, Joan’s critic was kicking her about some aspect of her appearance.  Joan’s mantra was ‘Stop this garbage!’  Joan screamed it internally and simultaneously snapped the rubber band.  Joan asked me how this technique worked. 

I stated, "By snapping the rubber band, you are emphasizing your stop commands and making successful thought interruption more likely.  The sharp stinging sensation breaks the chain of negative cognition and acts as a punisher so that the critic is less likely to attack in the near future.  The important thing is to catch the critic just as he starts, before he is allowed to do much damage.  If you snap the rubber band and internally scream your mantra whenever you hear the critic’s voice, the frequency of the critic’s attacks will greatly diminish." 

Think of your Joan.  Could a variation of the howitzer mantra technique benefit your client?

In this section, we have discussed obstacles to change manifested as habit and reflex.  The accompanying CBT technique is called The Howitzer Mantras. 

Peer-Reviewed Journal Article References:
Barnett, M. D., Maciel, I. V., & King, M. A. (2019). Sandbagging and the self: Does narcissism explain the relationship between sandbagging and self-esteem? Journal of Individual Differences, 40(1), 20-25.

Burke, E., Pyle, M., Machin, K., Varese, F., & Morrison, A. P. (2019). The effects of peer support on empowerment, self-efficacy, and internalized stigma: A narrative synthesis and meta-analysis. Stigma and Health, 4(3), 337–356.

Ezawa, I. D., & Hollon, S. D. (2023). Cognitive restructuring and psychotherapy outcome: A meta-analytic review. Psychotherapy, 60(3), 396–406. https://doi.org/10.1037/pst0000474

Hallis, L., Cameli, L., Dionne, F., & Knauper, B. (Jun 2016). Combining Cognitive Therapy with Acceptance and Commitment Therapy for depression: A manualized group therapy. Journal of Psychotherapy Integration, 26(2), 186-201.

Scimeca, G. (2023). Fear of premonition: A case report of cognitive therapy integrated with eye movement desensitization and reprocessing. Psychology of Consciousness: Theory, Research, and Practice. Advance online publication. https://doi.org/10.1037/cns0000369

Sewell, D. K., & Lewandowsky, S. (Aug 2012). Attention and working memory capacity: Insights from blocking, highlighting, and knowledge restructuring. Journal of Experimental Psychology: General, 141(3), 444-469.

Shikatani, B., Fredborg, B. K., Cassin, S. E., Kuo, Janice R., & Antony, M. M. (Apr 2019). Acceptability and perceived helpfulness of single session mindfulness and cognitive restructuring strategies in individuals with social anxiety disorder: A pilot study. Canadian Journal of Behavioural Science, 51(2), 83-89.

Shurick, A. A., Hamilton, J. R., Harris, L. T., Roy, A. K., Gross, J. J., & Phelps, E. A. (Dec 2012). Durable effects of cognitive restructuring on conditioned fear. Emotion, 12(6), 1393-1397.

Yilmaz Dinç, S., & Sapmaz, F. (2023). The effect of eye movement desensitization and reprocessing-based online group counseling for university students: Psychological need satisfaction, psychological resilience, psychological well-being, and small ‘t’ trauma. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. https://doi.org/10.1037/tra0001629

QUESTION 7
What is a CBT technique for overcoming obstacles to change in the form of habit and reflex? To select and enter your answer go to Test.

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