On the last track we discussed using alcohol to manage emotions. Two methods your client can use to manage emotions in a more productive way than by excessive alcohol use are systematic desensitization and dealing with unpleasant memories.
On this track we will discuss preserving positive self-concepts. Three Cognitve Behavior Therapy steps that you can use to help your clients in preserving positive self-concepts are increasing positive self-thoughts, decreasing negative self-thoughts and setting standards.
As you listen to this track, consider the methods of implementation to these three steps to preserving positive self-concepts. How can you adapt these three CBT steps to your controlled-drinking client?
#1 Increasing Positive Self-Thoughts
First, let’s examine ways of increasing positive self-thoughts.
Monty, age 42, had a daughter, Anna. Anna was in junior high. Monty’s drinking was a result of his negative self-concept. Monty stated to me, “Anna’s at that age where material things mean a lot to her. I understand where she’s coming from, but I just can’t buy her all the nice things that she wants! I never went to college, so I don’t make much money! School events are the worst! Other parents probably think I’m a failure when they look at the way my daughter is dressed in comparison to their kids!”
I stated to Monty, “A negative self-concept and the feelings of worthlessness that accompany it sometimes lead to drinking. Alcohol provides a temporary escape from these unpleasant thoughts and feelings.” Monty agreed that the escape from negative self-concepts provided by his alcohol consumption was only temporary.
I stated to Monty, “Set up some reminders for yourself to increase your positive self thoughts. For example, you can put a piece of tape on your watch or tie a string to your pen to remind yourself to think a positive self thought.” Monty replied, “How is that supposed to work when I don’t have any ‘positive self thoughts?’”
I responded, “You may not buy your daughter the most expensive clothes money can buy, but you do clothe her, right? And you make sure she has everything else she needs, right?” Of course, Monty affirmed that he provided for his daughter. I continued, “Then you’re a great parent that meets his daughter’s needs.”
Is your client having a difficult time coming up with positive self thoughts? If so, he or she might find it useful to make a list of positive remarks that apply.
Some of the positive self thoughts Monty used were:
What are some ways your client can increase his or her positive self thoughts? Would your Monty benefit from listening to this track?
#2 Decreasing Negative Self Thoughts
After Monty began to see how he could increase his positive self thoughts, I introduced him to some ways that he could preserve his positive self concept through decreasing negative self thoughts or self-talk.
Monty stated at a later session, “I’m trying to think positive, but there are still a lot of times I think bad things, too."
I replied to Monty, “If your negative thoughts aren’t decreasing, we can deal with them, too. One easy, but effective way of decreasing negative self thoughts is thought stopping. When you become aware of a negative self thought, imagine yourself yelling the word ‘Stop!’ as loudly as you can. Or tell yourself, ‘Thinking this way is hurtful to me. I choose instead to think _____ and then fill in the blank.’ This will interrupt the thought for a while. As you practice replacing negative thoughts with positive self-talk, learn to recognize the things you think about yourself that are negative thoughts.”
Some of the negative thoughts Monty had were:
“I’m too far gone to fix my life.”
“I’m too old to correct my mistakes.”
“I’m an alcoholic and I’ll never change.”
“What’s the use?”
At a later session, I read Monty the negative self thoughts he had reported having. I asked, “Do you feel a little down or anxious?” Monty did feel a little down after hearing his own negative self talk. I then read Monty the positive self thoughts that we had reviewed. I asked Monty, “After hearing these positive things that you think about yourself, do you notice a change in the way you feel?” Monty reported a noticeable change in his emotional stated.
Think of your Monty. Does your client’s self concept lead him or her to drink? Could decreasing negative self thoughts and increasing positive self-thoughts become a tool for controlled drinking with your controlled-drinking client?
#3 Setting Standards
In addition to decreasing negative self thoughts and increasing positive self-thoughts, a third CBT step you can use for preserving positive self-concepts is setting standards. To illustrate how setting standards can influence self-concepts, let’s consider Lauren.
Lauren, age 34, had been overweight most of her life. Lauren’s frequent weight loss failures often led her to binge drinking. At our first session, Lauren stated, “I had made a goal for myself to lose 75 pounds. I’m not going to be happy until I reach that goa!”
When Lauren wasn’t happy, she drank. I stated to Lauren, “If you’re not going to be happy until you lose 75 pounds, then you’ll be unhappy for a long time. Consider breaking down that goal into smaller steps. You might find that gradual change through moderate and sustained effort is easier than a sudden dramatic change that takes all you’ve got. If you set your standards so that every step toward losing 75 pounds makes you happy, you’ll be likely to feel better much sooner. This may help you control your drinking.”
Clearly, I was unable to give Lauren clear guidelines for deciding on realistic standards, but I did mention some of the signs she could watch for that might indicate that she had set her standards too high. I stated, “If you notice that you’re constantly failing to reach your goals, and that unpleasant feelings result followed by drinking, you might want to reexamine your personal standards.”
Would it also be helpful to explain to your client how emotional reactions to disappointment may lead to overdrinking? Would playing this track for your controlled-drinking client be productive?
On this track we have discussed preserving positive self-concepts. Three steps that you can use to help your clients in preserving positive self-concepts are increasing positive self-thoughts, decreasing negative self-thoughts and setting standards.
On the next track we will discuss relating to others. Three techniques for relating to others that we will discuss are forming relationships, learning from others, and managing relational conflicts.
What are three CBT steps that you can use to help your clients in preserving positive self-concepts? To select and enter your answer go to .