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 Section 7 Dessensitization and Cognitive Restructuring
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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 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 listen to 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 ReflexClients 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.   ♦ Technique:  The Howitzer MantrasTo 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 technique is called The  Howitzer Mantras.   
  In the next section, we will continue our discussion on obstacles to change by examining the  second category of obstacle.  This second  category of obstacles to change is feelings  of powerlessness.  The accompanying  technique in the next section focuses on overcoming  feelings of powerlessness. The Horwitz Mantras  are found in the following article: Frey, Diane; C. Jesse Carlock Practical  Techniques For Enhancing Self-Esteem.
 - Frey, D., & Carlock, C. J. (1991) Practical Techniques For Enhancing Self-Esteem. Accelerated Development Inc., 154.
 Reviewed 2023
 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 technique for overcoming obstacles to change in the form of habit and reflex? To select and enter your answer go to .
 
 
 
 
 
 
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