The College of Mental Health Counseling presents:
Transformative Counseling A Course in Empathy, Finding Wisdom: Verbalizing Your Inner Dialogue, Creative Solution Development, Counseling Assessment Self-Healing Life Story Questionnaire, Your Spirituality Score, Counseling for Depression
Daniel Keeran, MSW, President, www.collegemhc.com
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Copyright ďƒ“ 2014 by Daniel Keeran All rights reserved. No part of this book may be used or reproduced in any manner whatsoever without specific written permission from the author except for use in public schools and in the case of brief quotations in reviews for inclusion in a magazine, newspaper, or broadcast. Photocopies and electronic copies may not be sold. Special permission requests and inquires can be directed to the author at collegemhc@gmail.com
ISBN-13: 978-1503292567 ISBN-10: 1503292568
Printed in the United States. 2
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Dedicated to my loving wife and daughter
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Table of Contents A Course in Empathy: The New Revolution of the Heart
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Finding Wisdom: Verbalizing Your Inner Dialogue
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Counseling Assessment Self-Healing Life Story Questionnaire
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Reaching Agreement: Steps To Peace Through Creative Solution Development
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Your Spirituality Score
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Counseling for Depression
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About the Author
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A Course in Empathy The New Revolution of the Heart How do you think society might be affected if empathy was taught in schools? Imagine a world in which everyone, children and adults, knew how to care about how others feel and what they need, want, and think. While each individual has a unique capacity for empathy, some more than others, perhaps empathy can be assisted and encouraged for those who possess this aptitude. For example, empathic development may require an awareness of one's own emotions in order to begin to feel connected with the emotions of others. Now for the first time, we have a set of tools to actually learn empathy so that it becomes part of one's way of relating to others. In this short section, ten practical exercises are described to enable the development of empathy and thereby aid the transformation of the self, the community, and the human community.
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1 Introduction: What Is Empathy? Lesson Objectives: 1. To understand empathy. 2. To acquire an increased sense of empathy for the emotions and circumstances of others. Empathy Definition: To sincerely and accurately feel and reflect the specific emotion(s) of another person. Empathy also means to value others’ emotions. Why teach and learn empathy? The important reason to teach and learn empathy is that if individuals are able to learn empathy skills, they will be most likely to apply the skills in their current life with peers and future adult relationships. The ability to have empathy is important as a foundation for caring and compassion between and among people and contributes to positive relationships in all areas of life. Empathy builds a sense of community and reduces the tendency to discriminate or exclude others. Someone who bullies or excludes others can benefit from being aware of the emotions of a potential victim and to value those emotions. While some people may have difficulty feeling or communicating sincere empathy more than others, everyone will derive some benefit from the exercises in this lesson. Select those exercises that correspond to the overall capacity of the age group and modify exercise descriptions for the comprehension level of the group. Group Discussion: 1. What is empathy? How are empathy and sympathy 10
different? Empathy is not sympathy. Empathy means to feel the emotion of another person. Sympathy means to agree with the thoughts of another person. 2. Empathy means that you must set aside your own thoughts and feelings and pay attention only to the other person’s thoughts and feelings. Why does this ability require inner strength? 3. How is empathy communicated? Empathy is communicated in the sincere accurate reflection of the emotions of another person, conveyed in accurate facial expressions for the emotions, accurate voice tones for the emotions, and accurate words for the emotions. 4. How are thoughts different from emotions? Emotions are not thoughts. Emotions are sensory experiences in the mind and body such as relaxed, fear, caring, anger, guilt, happy, sadness, confident, low self-worth, hopeful, despair. Thoughts are ideas about another person, thing, or situation. 5. What is sincerity and why is it important? Sincerity means to be genuine, to truly value the other person’s feelings as important, and to take his or her feelings seriously. If sincerity is missing, then empathy will not be communicated. 6. Are emotions OK? Yes. Emotions are neither good nor bad. Having emotions is an important part of being human. Believing this is necessary in order to have sincere empathy for another person’s feelings. What you do with an emotion can be healthy or unhealthy.
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2 Exercises For Empathy Training Exercise One: Building Your Emotion Vocabulary Description: The leader introduces the exercise by saying that having a vocabulary of words for different emotions, is helpful for making sentences that communicate empathy. Many feeling or emotion lists can be found on the internet. Emotions can be separated into categories of pleasant and painful feelings. For example, pleasant emotions are: happy, excited, peaceful, relaxed, calm, hopeful. Examples of painful emotions are: fear, anger, guilt, sad, empty, low self-worth, and despair. An acronym can be used to help remember a list of words. For example, the acronym FAGSELD is a way to remember the painful emotions listed above. More information: Painful feelings can be divided into hard and soft emotions. Examples of hard painful feelings are anger, frustration, irritation, and annoyed, while examples of soft painful feelings are fear, sadness, guilt, emptiness, low self-worth, and despair. Invite group members (in group or as an assignment) to make a list of emotions or feelings they have about different experiences during the day. Examples: waking up, getting dressed, smelling breakfast, getting on the bus, hearing people arguing, hearing people laughing, entering the room, sitting at the desk, listening to the teacher, going to recess, taking a test, having lunch, doing homework, seeing parents, playing with friends, sitting down to dinner, going to bed. 12
Post-Exercise Discussion: 1. What do you realize about emotions and experiences? 2. Why is it important to be aware of your emotions as you feel them in the moment? 3. How does being aware of your own emotions affect the way you understand other people and things that happen in their lives? Assignment: Make a list of your experiences between the end of group today and the next group meeting and then write the emotions related to each experience.
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3 Exercise Two: Distinguishing Emotions and Thoughts Description: In this exercise, group members are asked to make three sentences beginning with “I feel” followed by a feeling word such as happy, sad, frustrated, or other emotion. Examples: “I feel happy when it’s time to play.” “I feel excited when I get to do math.” “I feel sad when my friends have to go home after visiting.” More information: Remember that a thought, instead of an emotion, is expressed if “I feel” is followed by the word “that” rather than a feeling word. The phrase “I feel that....,” really means “I think” or “I believe.” If you begin a sentence with “I think” followed by an idea such as “I think this subject is interesting” or “I think this group is fun,” you are communicating a thought instead of an emotion. Post-Exercise Discussion: What is the difference between a thought and a feeling? A thought is an idea. A feeling is an emotion.
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4 Exercise Three: Making Sentences for Empathy Description: Practice making sentences that communicate empathy using this form and words from the feeling list. Fill in the blanks, followed by checking to see if you are accurate: “You feel____________ because ___________. Is that accurate?” Scenario examples: Here are examples of two scenarios followed by examples of sentences that show empathy and checking for accuracy. 1. Jill has a frown on her face and says her best friend just moved away. Empathic reflection: “Jill, you feel sad because you best friend just moved away. Is that what you feel?” 2. Dad is very quiet when he comes home from work and says he just lost his job. Empathic reflection: “Dad, you feel worried because you lost your job. Is that what you feel?” Practice Scenarios: After each scenario below, write a sentence that shows empathy followed by checking to see if you are accurate. 1. Your brother comes home crying and then says he was called hurtful names at school. 2. The boy at school that others just called hurtful names, is sitting quietly and looking down. 3. Your friend says he does not want to go home because he received low scores on his report card. 16
4. Your friend says she can’t invite you over because her Mom doesn’t feel well. 5. A person at school is sitting alone at lunch time and not eating his lunch. Post-Exercise Discussion: 1. What questions do you have about writing a sentence that shows empathy? 2. Why is it important to check to see if you are accurate?
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5 Exercise Four: Role Reversal Description: In the Role Reversal exercise, empathy skills are increased when individuals are asked to imagine he or she is someone else who will be interviewed in pairs. The group is divided into pairs, and each person takes turns telling the other person basic personal information in answer to a brief set of questions. Then each person imagines he or she is the other person and speaks to the group in the first person as if he or she is the other person. Mary interviews Rosie and then presents herself as if she is Rosie by saying, “My name is Rosie. I am 12 years old,” etc. Then Rosie does the same by saying, “My name is Mary. I am 12 years old,” etc. Accuracy is important for building empathy skills in this exercise. The following is a list of basic questions for collecting basic personal information: 1. 2. 3. 4. 5. 6.
What is your name? What is your age? What is your favorite color? How many brothers and sisters do you have? Where did you go on vacation? What do you like to do most?
Demonstrate to the group: “Now I need a volunteer to show you what role reversal looks like. Who would like to volunteer?” The leader asks the above questions to the volunteer as you sit together in front of the group. Then the leader presents herself as the student speaking in the first person and relating the information collected in the interview using the questions above. 18
Then the leader says, “What questions do you have about what you will be doing?” Instructions to the group: “Now I want you to divide into pairs and interview each other using these questions (written on the board or given as a printed handout). Remember what the other person says, and then you will present yourself as if you are the other person starting with the name and so on. You will have to listen very carefully and remember what the other person said. What questions do you have about what I am asking you to do?” Post-Exercise discussion: 1. What was it like hearing your partner speak as if he or she was you? Was he or she accurate? 2. What was it like being your partner? What did you feel or think when you were being someone different than yourself?
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6 Exercise Five: Doubling Description: In the Doubling exercise, similar to the Role Reversal exercise, the individuals build empathy skills by becoming a double or alter ego for another person. This is done by inviting students to walk around the room in pairs (or to sit in chairs in parallel position) while one speaks as the other doubles. The speaker talks about a happy memory or expected future event. As the speaker is talking, the Double also talks in the first person as if he or she is also the speaker and reads between the lines by inserting feeling words. Example: Speaker: “I am going to visit my grandparents next week.” Double: “And I feel happy.” Speaker: “My grandma makes the best cookies.” Double: “I am excited to eat the cookies.” The speaker can let the Double know if she or he is accurate or not by saying what the accurate feeling is. Demonstrate to the group: “Now I need a volunteer to show you what Doubling looks like. Come here and sit with me (chairs in parallel position facing the group). Talk about a happy memory or something you look forward to in the future.” As the volunteer talks, the leader speaks in the first person as if she or he is the student and fills in feelings or emotions not spoken by the volunteer. 20
After a brief while, the leader turns to the group and says, “What questions do you have about what I am asking you to do?� Instructions for the group exercise: Divide the group into pairs, and as they are engaged in the exercise, let them know when to switch roles with one as the speaker and the other as the Double. Post-Exercise Discussion: After each person has had an opportunity to experience both roles (speaker and Double): 1. What was it like being the speaker and hearing the Double speaking as yourself? 2. What was it like being the Double? What was the hardest part? 3. How did the exercise of Doubling help you understand the other person?
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7 Exercise Six: Listening with Empathy Description: Practice listening to another person talk about something that is personally important, and make sentences for empathy that reflect his or her emotions. Remember that empathy means to set aside your own thoughts and feelings and to pay attention to what the other person thinks and feels. Demonstrate to the group: “Now I need a volunteer so that I can show the group what a sentence for empathy sounds like. Think of something you can say about what is important to you or something that happened or you hope will happen in the future. Who would like to volunteer?” After a brief demonstration, thank the volunteer and ask the group, “What questions do you have about what you will be doing?” Instructions for the group exercise: “Now we will practice making sentences for empathy. I want you divide into pairs. One of you will speak for a little while and the other will listen. The speaker can talk about something that happened last night or today or something in the future. The listener will make a sentence for empathy and check to see if it is accurate. Then I will tell you when to switch, with the speaker becoming the listener, and the listener becoming the speaker. Remember that empathy means to set aside your own thoughts and feelings and to pay attention to what the other person thinks and feels.” After giving instructions, ask the group, “What questions do you have about what you will be doing?” 22
Post-Exercise Discussion: 1. What was it like being the speaker and hearing the listener make sentences for empathy (reflections)? 2. What was it like being the listener? What was the hardest part about it? More information: In making an empathic reflection, an overstatement of the other person’s thoughts and feelings can give added support when the reflection is accurate and sincere. This involves seeing implications of what the speaker says and including these implications in the sincere reflection while being careful to check for accuracy. If the empathic reflection is an understatement and leaves out accurate basic information given by the speaker, the speaker will feel a lack of empathy and support. Additional exercises can be created to assist group members to recognize and reflect empathy for different specific emotions such as fear, anger, guilt, sadness, celebration, humiliation, and others. See an exercise for empathizing with anger below.
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8 Exercise Seven: Becoming Another Character Description: In this exercise, members are asked to break into groups of three to do the following: 1. Write the dialogue for and then enact a scenario for three people: a victim, a bully, and an observer. 2. Each group enacts the scenario three times. Each time the scenario is enacted, each person rotates to take on the role of a different character. 3. After all scenarios are enacted with each person rotating to each role, each person then discusses what it was like to take on the role of each character, what emotions were felt, and what thoughts came up in each role. Post-Exercise Discussion: 1. What emotions did you feel as the bully? 2. What emotions did you feel as the victim? 3. What emotions did you feel as the observer? 4. What decisions have you made after doing this exercise?
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9 Exercise Eight: Understanding the Story Description: This exercise is about understanding the story of another person. “An enemy is someone whose story you have not heard.� 1. Ask members of the group to think (and write) about someone they are afraid of or someone with whom they do not want to be friends and to give a reason. 2. Ask group members to imagine they found out reasons why the person behaves in a negative way and to write the reasons down. 3. Ask group members to share how they feel about the person after realizing there may be a story that explains the negative behavior of the person. Example: (corresponding to the three points above) 1. I do not want to be friends with Rosie because she never talks to me. 2. I found out that Rosie is unhappy and lonely at home, and she is afraid her Mom may not be able to pay the rent. 3. Now that I know this may be true, I want to be friends with Rosie because her not talking is not about me but about her feelings about what is happening at home. Post-Exercise Discussion: 1. How has this exercise changed the way you think about people you are afraid of or with whom you do not want to be friends? 2. Imagine how understanding the story of the other person could affect the way people feel and think about their perceived enemies, nations in conflict, and groups of people that you or perhaps others dislike. 26
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10 Exercise Nine: Imagine the Emotions of a Historical Character Description: This exercise is about understanding the emotions of a historical character. The leader asks group members to make a list of five people from history and circumstances. Then write emotions that each person may have felt about what was happening in history or in the life of the person when they were experiencing the emotions. Alternatively, the leader can make a list of historical people, describe their circumstances, and then invite group members to list emotions the person might have had. Example: Abraham Lincoln sees slaves being sold in the town square, and in that moment he feels sad that they have no families of their own, angry that men would treat other men as property, and hopeless that he could do nothing about it. Post-Exercise Discussion: 1. Who would like to share your list of historical people and circumstances with the group? 2. What emotions did you come up with and what are the emotions about?
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11 Exercise Ten: Having Empathy for Anger Description: This exercise assists the development of ways to cope with the anger of another person by using empathic reflection. Empathy for anger can sometimes have the effect of reducing the anger of a person. A scenario is demonstrated by the leader who makes a reflective empathic statement when someone is very angry. After observing this, group members are asked to form pairs and to practice making a reflective empathic statement to the other person who makes an angry statement. Example: (demonstrated) Angry Person: “You never do what you’re told, and so now I have to do it for you.” Empathic Listener: “You feel angry because I didn’t do my work, and that makes more work for you. Is that what you are feeling?” Following this demonstration, ask group members to enact the same scenario in pairs with each person taking turns being the angry person, then the empathic listener. Use the statements provided in the above example and repeated them to help you feel more of the emotion and what it is like to say and hear the words. Post-Exercise Discussion: 1. What was it like making the angry statement? 2. What was it like making the empathic reflective statement? 3. What was it like as the angry person hearing the empathic reflective statement of the listener? 30
4. Imagine how empathic reflection could be used between nations to reduce hostility. How could it work?
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Finding Wisdom Verbalizing Your Inner Dialogue New generation psychological technology can improve conditions in persons with normal or average cognitive functioning. The cognitive mental functions give humans a particular advantage in terms of creative solution development. Humans are constantly engaging in a process of internal dialogue across a variety of subject areas. Mental distress may be at least partly remedied by verbalizing, understanding, and perhaps modifying the internal dialogue. For persons suffering from chronic dependency as well as anxiety, depression, and relationship issues, the following technique may be useful: 1. Invite the client to talk about what they know will improve their situation and what could worsen their situation. 2. Identify the parts of the self as the knowing confident self and the unknowing negative self. 3. Ask the client to verbalize each part of the self in response to the other (like Golum in Lord of the Rings). 4. Discuss ways to strengthen the knowing confident part of the self. This is also the observer will part of the self that is able to evaluate and modify the dialogue and draw a conclusion that works best. The above technique can be easily learned, recorded through journaling, and repeated as a core process in therapy in order to make the inner dialogue most conscious and useful to the client. This psychological technology can improve conditions in persons with normal or average cognitive functioning. The therapeutic use of inner dialogue can focus on a specific issue or area of mental distress and invite the client to have a 32
conversation between the knowing confident part and the negative self-doubting or unhealthy part. Here is an example of an exchange using this inner dialogue approach: Client: I feel so inadequate and lacking in self-confidence. Counselor: So, part of you feels inadequate and lacking in self-confidence. I wonder if there is another part of you, a knowing part, even a small part, that feels adequate and confident about some things. Client: Yes, there is. I moved out here on my own. I have a job and pay my rent (client smiles). Counselor: You are very resourceful, capable, and independent. You can strengthen the positive, capable part of yourself just by talking more about it. Tell me more. In this example the counselor further supports the knowing supportive self by adding to the dialogue. The counselor can also invite the client to verbalize the inner dialogue between the positive knowing part and the negative doubting part. Counselor: Now I want you to speak your negative thoughts and also your positive thoughts.
An exchange with someone suffering from depression Counselor: If there’s a conversation inside you about the depression, how does it go? Speak the conversation out loud. Client: I am a failure. Nothing I do is good enough. Counselor: So that is the negative part of you that feeds the depression. There is another part of you, even if it is a small part, that knows more and that can see the big picture. What does that part say?
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Client: I have been resourceful, independent, and self-reliant. I pay my own rent, buy my own food, hold a job, moved far from home, and have travelled to Europe on my own. Counselor: Yes. Which part of you feels better than the other part of you: the negative part or the other part?
Working with different personality disorders The beginning of the process is to identify the central issue defining the personality disorder. Personality disorders are understood as a pattern of behaviour beginning in childhood, causing subjective distress and affecting social and occupational functioning. The central issue of each disorder is actually the voice of the negative unhealthy self that is larger or stronger than the positive confident self. The goal of therapy is to strengthen the positive confident self and thereby relieve mental distress. This occurs by bringing the inner dialogue into conscious awareness and by focusing attention on the positive healthy confident self by talking about, elaborating, and affirming it. The negative unhealthy self is significantly fed by negative uncaring experiences during childhood, usually the parental relationship. A way to strengthen the positive self is to say, “What would you say or do if what happened to you happened to your own child?” and “If you were the healthy caring adult or parent in the situation you describe, what would you say or do for you, the child?” This approach utilizes the person’s own cognitive ability and sense of empathy to create and define healthy choices. Another approach is to say, “If you had power to change any three things about your childhood or family when you were growing up, what would they be?” and, “I wonder if you can imagine how you might be different today in some ways if things had been different as you describe.” 34
This approach helps the person use memory to identify significant unresolved issues from childhood that require healing as well as visualization in order to identify and strengthen the positive healthy self. A key to moving forward is to hold two opposite realities simultaneously, the reality of loss of parental caring or other loss and also one’s power to make healthy choices in thought and action now: “Maybe you could not choose what happened in your childhood, and you can choose what you do now.�
Paranoid Personality Disorder Central issue: No one can be trusted because they want to harm me in some way. Common associated major negative life experience: Loss of caring and closeness in the parental relationship during childhood. Possibly physical or verbal abuse. Therapeutic statements supporting the healthy self: What happened in your childhood or your past that you think has contributed most to your distrust of others? I wonder if part of you knows what someone would be like if they could be trusted. How much is your fear and distrust based on what you think about other people? If you could allow yourself to think differently about others, how might your fear be affected? How would you feel toward others if you could believe that people are generally sincere and well-intentioned?
Schizoid Personality Disorder Central issue: No one understands me because I am different. I prefer to be alone. Common associated major negative life experience: Childhood abuse, loss of parental caring, bullying.
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Therapeutic statements supporting the healthy self: When in your life did you first start feeling alone or of being lonely? What happened in your childhood or your past that you think has contributed most to your desire to be alone? I wonder how you might be different today if there had been something different in your life when you were growing up. What is your image of the person you want to be? Describe this person for me. Part of you prefers to be alone. Another part of you has a different need or different idea about people. What does that part say?
Schizotypal Personality Disorder Central issue: I have odd or delusional thoughts but I may not recognize them as odd or delusional; no one can be trusted. Possible abuse or abandonment experience in childhood. Common associated major negative life experience: Loss of parental caring; lack of social skill development in childhood. Therapeutic statements supporting the healthy self: Part of you thinks what you described (the odd thought) is true, and maybe you need to have those thoughts for now. Part of you believes no one can be trusted, and everyone wants to harm you in some way. There is another part of you that may have a different idea about your thoughts and knows what you need and who you can be. What does that part of you say?
Antisocial Personality Disorder Central issue: I am willing to violate the rights of others to serve my own profit and pleasure. 36
Common associated major negative life experience: Lack of parental discipline during childhood; loss of parental caring. Therapeutic statements supporting the healthy self: Part of you is use to surviving on your own, believes sometimes you must take advantage of other people to look after your own interest, and that the end justifies the means. Is that accurate? There is another part of you that feels a little guilty about taking advantage of others to meet your own needs. What does that part of you say?
Borderline Personality Disorder Central issue: I don’t have control over my emotions. “I hate you, don’t leave me.” I am afraid of abandonment. Common associated major negative life experience: Abuse and/or abandonment during childhood. Therapeutic statements supporting the healthy self: Part of you hates people, feels emotionally negative toward others, and also fears being left alone by others. Who was the first important person in your life who hurt or left you? Another part of you, perhaps a small part, believes that you are capable of being OK and surviving even if people leave you. What else does that part know? Maybe that you can manage your emotions, especially your anger?
Histrionic Personality Disorder Central issue: I need the attention and approval of others in order to be happy. My worth depends on my physical attractiveness. Common associated major negative life experience: Childhood abuse and learning to believe that value is associated with sexuality or external appearance. Lack of training in healthy values and beliefs during childhood. 37
Therapeutic statements supporting the healthy self: Part of you believes your worth depends upon your sex appeal and physical appearance. There is another wiser part, even if it is a small part of you, that knows more about you and your worth as a person. What does that part say?
Narcissistic Personality Disorder Central issue: My ideas and abilities are superior to those of others. Common associated major negative life experience: Parental abandonment or rejection by the father. Therapeutic statements supporting the healthy self: Part of you thinks your ideas and abilities are superior, perhaps far superior, to those of others. Another part of you thinks you may be an imposter or feels very inferior to others. What does that part say? And part of you thinks others are capable of having important ideas and abilities. What does that part say?
Avoidant Personality Disorder Central issue: I am afraid that others will criticize me in social situations. Common associated major negative life experience: Critical parenting during childhood or bullying by peers or siblings. Therapeutic statements supporting the healthy self: There is part of you that is afraid of criticism in social situations. Another part of you is able to reassure you or encourage you. What does that part say?
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Dependent Personality Disorder Central issue: I fear being alone and must subordinate my own needs and feelings to those on whom I rely. Common associated major negative life experience: Dominating parenting that makes obedience and subservience a condition of caring. Therapeutic statements supporting the healthy self: Part of you believes you must serve others in order to be accepted by them, and you must be accepted by them in order to be happy. Another, knowing part of you believes you are worthwhile even if others do not accept you. This part wants you to be true to yourself and to assert your own needs and feelings even if others are displeased. What else does it say?
Obsessive-Compulsive Personality Disorder Central issue: I must control my environment and finances, because of my fear of chaos, disorder, or poverty. Things, working, and financial security are more important than people. Common associated major negative life experience: Poverty or financial stress or financial loss during childhood. Therapeutic statements supporting the healthy self: Part of you thinks you must achieve and maintain financial security even if you must sacrifice closeness and caring in your relationships with others. If that seems accurate, elaborate on this a little. Another part of you believes people and the quality of your relationships are more important than things or even than keeping order.
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Counseling Assessment Self-Healing Life Story Questionnaire Instructions: Only say as much as you want to. Skip questions that are too uncomfortable, but think about why they are. Simply completing this questionnaire can be a healing experience in itself. To understand the deeper meaning of the questions and your answers, consider this important resource Effective Counseling Skills.
Introduce Yourself 1. What is your first name? 2. What is your age and gender? 3. What is your marital status? Single, married, separated, or divorced? How long? Explain the reasons for separation(s) or divorce(s). What happened? 4. What is your race, ethnic, or cultural background? Caucasian, Chinese, East Indian, Aboriginal, Other? 5. What are your children's genders and ages? If they are adults, give their occupations and marital situation. 6. Do you live alone or with someone? How long?
What Happened? 7. What problems and concerns do you have now? 8. What emotions have you been having and what is each one about? Fear, anger, frustration, guilt, sadness, low self-worth, despair, other feelings? 9. How long have you been feeling this way? (for each feeling or problem) 10. What happened at the time you began feeling this way? 11. When have you felt like this in the past and what happened? 12. Any health problems? E.g. epilepsy, diabetes, etc. 13. Any counseling or hospitalized for emotional reasons? How old were you? Please give the reasons. 40
The Family You Grew Up In and Your Childhood 14. How many brothers and sisters do you have? Give each person's gender, age, occupation, and marital situation. 15. Which one are you in the line of birth? First, last, second or third, etc. How many years separate you from the others nearest you? 16. Who were you closest to when growing up? 17. Are your parents still living? What was your age at their death? 18. Have your experienced any other deaths of family members or friends? What was your age? 19. Describe your father's (and step-father's) personality and your relationship to him when you were growing up. Were you close, not so close, distant, affectionate? Give an example of something that happened that shows this and how old you were. 20. Talk about how your relationship with your father (or father figure) during childhood may have affected you in both positive and negative ways. 21. How have the negative experiences with your father figure(s), come up again in your relationships with other people up to now? 22. Describe your mother's (and step-mother's) personality and your relationship to her when you were growing up. Were you close, not so close, distant, affectionate? Give an example of something that happened that shows this and how old you were. 23. Talk about how your relationship with your mother (or mother figure) during childhood may have affected you in both positive and negative ways. 24. How have the negative experiences with your mother figure(s), come up again in your relationships with other people up to now? 41
25. What were your spiritual or religious beliefs before age 10 and how have your beliefs changed since then? 26. What was your role in the family when you were growing up? Think of a word, e.g. peacemaker, black sheep, victim, outsider, assistant parent, invisible, baby, etc.? Give an example of what happened. 27. Describe your parents' relationship. Were they affectionate? How did they deal with conflict? Give an example of what happened. 28. Was anyone in the family or extended family ever hospitalized for emotional reasons or commit suicide? Any mental retardation? 29. How did family members relate to each other when you were growing up? Give an example. 30. How were feelings of anger, sadness, fear, and guilt expressed? Give an example. 31. Describe a time when you were disciplined that was most painful for you. How old were you? What happened? 32. What personality features do you have which your parents also have? 33. Who was there for you when you were hurt as a child? 34. What messages about your worth and the worth of others, was communicated by each parent both verbally and nonverbally? 35. How old were you when you left home, and why did you leave? 36. If you had power to change your family when you were growing up and your childhood in any three ways, what would you choose? 37. If your family experience had been different in the ways you mentioned above, how do you imagine your life might be different today? 38. Do you know if your mother had any problems with your birth? 42
Your School Experience and Friends 39. What was the first day of school like? 40. How many moves and school changes occurred during school years? How old were you, what grades did you move and why? 41. Describe your relationships with teachers. 42. Describe your relationships with peers. 43. Do you believe you achieved your best in school? Why? What grade or education level did you complete? What happened? 44. Did you have a group of friends during the first six grades? If not, why? 45. Did you have one or two very close friends as a teenager? If not, why? 46. Did you tend to be a follower or a leader with friends as a teenager? 47. How old were you when you first started go out with someone (or dated)? 48. Do you have a satisfactory network of friends, family, groups? Describe these briefly. 49. How would you describe the types of people you associate with? (What is your role with friends and acquaintances? Helper, victim, other?)
Your Work Experiences 50. How old were you when you first went to work? 51. What types of jobs have you had and how many? Why did you leave each job? 52. What has been your role at work? Helper, invisible, responsible, victim, other? And how have you gotten along with bosses?
Your Social Life and Relationships 53. What was your first date like for you? 43
54. How old were you with your first sexual experience? And first intercourse? 55. How many sexual partners have you had over time? And what is your sexual preference or orientation? (heterosexual, homosexual, bisexual) 56. Describe your partner’s personality and your relationship. Aggressive, passive, abusive, caring, other? And describe previous meaningful relationships, their personalities, and why they ended.
Your Legalities, Use of Substances, Financial Situation 57. Have you had any past arrests, warrants, charges, suits against you? How old were you and what were they about? 58. What amount of debt do you have? 59. Any drug or alcohol use? Why do you use it? Has anyone complained that you use too much or too often?
Your Mood 60. Have you ever had suicidal thoughts at any time in your life? How old were you? What happened? 61. What is your mood right now on a scale of zero (0) to 10, with zero meaning ‘life is not worth living’ and 10 meaning you are very optimistic and life is wonderful? What number do you give your mood? 62. Any thought of wanting to harm yourself or anyone else?
Your Final Thoughts and Understandings 63. What are your greatest strengths? And what skills or abilities do you currently have the most confidence in?
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64. Having looked at your life from early days until now, what do you think may have contributed most to your present difficulties? 65. Of all the questions above, what has been most difficult for you to face? 66. If you were to continue on a path of change and growth what would you hope to achieve or what would be your goals in counselling? 67. What has it been like completing your Life Story Questionnaire?
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Reaching Agreement Steps To Peace Through Creative Solution Development* The process can involve a single individual, a couple, two or more parties having issues, or a large group, and moves beyond control to mutual agreement or majority decision. Explain that the process depends upon acceptance of the following guidelines by all participants: 1. Do not judge, criticize, or evaluate any ideas as you engage in the solution development process. 2. Do not use attempts to exercise power or control of any kind: such as anger, yelling, name-calling, put-downs, threats or intimidation or manipulation. Step One: Identifying Issues 1. The facilitator invites participants to say “what issues and challenges need to be addressed.� 2. The facilitator writes these issues in a numbered list on a chalk board or flip chart. (As the issues are being stated, the facilitator uses reflective listening as needed in order to clarify meaning. In the event a strong emotion is expressed or a participant becomes too verbal, the facilitator uses reflective statements, checks if the person feels understood, then directs the participants back to the issue.) 3. The facilitator then asks members to say the number of one of the listed issues that he thinks needs to be addressed first. 4. The facilitator makes a tick by the number of each listed issue selected by participants, then circles the one with the most ticks; this becomes the first issue for solution development. 46
Step Two: Creating Solutions 1. Writing the issue on the chalkboard or flipchart, the facilitator makes a numbered list below it and says, “Now I would like us to brainstorm as many solutions for this issue as you can think of, and as you state them I will write them down on this list without judgment, criticism or discussion.” 2. To increase the number of ideas and with writing material, large groups can break into small groups or dyads and brainstorm using the following statements presented by the facilitator: a. Let’s write down what’s happening now, because that is always a choice. b. What’s the opposite of what’s happening now? c. What is a fantasy of what you might like to see happen but you don’t think is possible? d. Think of an approach that seems silly or ridiculous. e. Imagine what someone you respect (a relative or other wise person) might say as a solution. f. I can think of a possible solution that would work well and that no one has mentioned. Can anyone quess what it is? (the facilitator writes down ideas the participants guess) g. My idea is ...... (facilitator adds his or her solution to the numbered list) Step Three: Reaching A Creative Agreement 1. The facilitator says: “Now using your writing material, I would like each of you to take a separate sheet of paper and privately write down the number of up to three of the listed possible solutions or approaches that you think would be most practical or workable to address the challenge or issue.” 47
2. The facilitator says: “Now tell me the number of the listed solutions you have chosen, and I will make a tick by each of the solutions.� 3. The three solutions most selected by the participants become the creative agreement or solution strategy for the issue addressed. 4. Depending on the issue, volunteers can be invited and a time can be determined to implement the strategy or action plan. 5. Repeat Step Two and Step Three for the second, third, fourth, etc. issue selected most often by the participants. *If the conflict is related to differences in philosophy, religion, personal taste, or if agreement cannot be reached, the following approaches may provide a solution: agree to disagree, flip a coin, take turns or agree to separate or alternating action plans, implement trial time periods to try different plans, or return to the above process. Additional information is found in the practical manual How To Do Professional Mental Health Counseling.
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Your Spirituality Score Spirituality provides values and beliefs for making healthy choices, a foundation of hope and meaning for direction and optimism, and support and encouragement to face major life difficulties. Strengthening your spiritual growth and awareness can set you on a path to find inner peace, physical and mental healing, and personal fulfillment. Your Spirituality Score is based on how many questions of the total for which you can provide a confident answer, rather than saying, “I don’t know.� Responses can be written, verbal, or mental, but written may be beneficial for most people. 1. What is your age, gender, and ethnic/race origin? 2. What were the spiritual/religious views of your father? Your mother? 3. How has your spirituality changed from your childhood until now? 4. Is there anything more than the material universe? Do you believe anything is true that you cannot personally and directly perceive with your five senses? Explain. 5. Do you believe intelligence and creativity exist in the universe? Explain. 6. Do you believe in the existence of a transcendent intelligence or superior reasoning power? Explain why or why not. 7. Do you see evidence of creative intelligence in the design and complexity of the universe or do you lean toward a material natural explanation? 50
8. Do you believe all human beings have equal worth and value? Explain why or why not? What are the implications? 9. Do you believe the human species has greater or superior value or greater importance or more responsibility compared to other life forms? Why or why not? What are the implications? 10. What is the meaning or purpose of human existence? 11. How do you know what is right and wrong? 12. What is the most important thing you can do with your life? 13. Is hope important? Explain. 14. What happens after you die? Does your individual identity or consciousness continue to exist? What are the implications? 15. Is the idea of the meaning of human life essential to the idea of hope? Explain. 16. Is the idea of right and wrong essential to the idea of meaning? Explain. 17. What have been some of the most important influences on you for what you value and believe? 18. What spiritual practices do you have? Prayer, centering prayer, meditation, scripture reading, worship, singing, other. 19. Does moral accountability only happen within the legal systems of nations? Is there ultimate accountability in a venue after death? What are the implications? 20. If people are reborn into new lives, what if anything determines the nature or quality of their existence? What are the implications? 21. Comment on this statement: “Many people think only tangible things are real, yet the same people admit intangible 51
things are most important: love, compassion, empathy, justice, morality, consciousness, wisdom, human value, meaning of life, and eternity... for without these, life is void and vain, and aspirations mere illusions.” 22. Have you ever experienced what you believe to be a sign or communication from God or other spiritual being? 23. What is your view of this statement? “Humans are spiritual beings existing in physical bodies.” 24. Do you believe you have convincing evidence of spiritual reality? 25. What is your idea of an ideal society? World? Life? 26. When does an individual human life begin? 27. What is the essence of the self? 28. Do you believe angels and demons exist? 29. Do you believe everyone after death goes to heaven or to hell? 30. Do you believe the superior reasoning power has ever communicated with humanity? 31. How open are you to exploring different aspects of spirituality? 32. If you saw someone raise the dead, what would you think or do? 33. If you saw a person die and then you saw him alive again a few days later, what would you think or do? 34. Comment on the statement: “Humans are a parasite infestation of the earth.” 52
35. How can you prove to anyone else that you are aware of yourself, your own consciousness? 36. Describe a healthy relationship. 37. How important is your spirituality to your life? And do you want your spirituality to increase or decrease? 38. If we are made in the image of God, what qualities do we share with God? 39. Read Isaiah, chapter 53, written in 700 BC. Who is being described? See other amazing examples of future-telling here or http://goo.gl/uM1e7p 40. Do you now belong to or have you thought of joining a spiritual community to strengthen your values and beliefs for making healthy choices, to acquire a foundation of hope and meaning for direction and optimism, and to receive support and encouragement to face major life difficulties? 41. How has this questionnaire affected your awareness of your belief in non-material things? Final instructions: Count the number of questions for which you struggled to give a sincere answer, and then subtract the number from the number 41. The answer is your Spirituality Score. How to use this assessment: Whatever your score may be, give further consideration to questions you are unsure about or for which you have difficulty giving a response.
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Calculating Your Spirituality Score 1. Make a mark indicating any question for which you feel unable to give a satisfactory answer or that you find especially challenging. 2. Add the number of marks in #1 and subtract this number from 41. 3. The answer to #2 is your Spirituality Score. NOTE: This score and your answers to questions are to be used only by you and anyone to whom you grant permission. Total number of questions
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Number of difficult questions Your Spirituality Score
For assistance to explore or discuss your score, email collegemhc@gmail.com
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Counseling for Depression Depression can be caused by chemical changes in the body, physical illness, and different types of loss. Very often, depression and anxiety are the result of self-defeating life patterns forming unhealthy neural pathways that can be healed by incorporating caring self-talk and by supporting self-worth and assertiveness. We tend to do to ourselves and to others that which was done to us in childhood. Now as adults we must give to ourselves all the healthy things we needed from healthy parents. Here are some things to do to change the innerdialogue foundations of depression and anxiety: Step 1. Write down the negative things you think about yourself, others, and your circumstances. This activity will bring to your conscious awareness the negative thinking and self-talk that is common to many kinds of depression and anxiety. The negative and self-critical self-talk demoralizes the ego and manifests as feeling down, blue, sad, anxious, fearful and self-doubting. This low mood and anxiety then affect sleeping, eating, and low energy. Common examples of negative self-talk are: I am incapable, I can't do it, I am unlovable, I am a failure, I failed again, I can't do it, No one wants to talk to me, No one cares about me, etc. Step 2. Write down statements that are self-caring, nurturing, reassuring, supportive, and validating. This exercise helps to identify the opposites of the negative self-talk: I can do it, I have strengths and abilities, I am caring and kind, I can get what I need and want, I deserve to be happy, I can succeed, I am just as important and valuable as anyone else, My pain is normal for what I have been through, etc.
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Step 3. Write down negative things parents said or communicated to you when you were growing up. Here you can write down what you thought parents felt about you by what they said or did such as: I wish you were never born, I do not like you, I do not care about you, I care about alcohol more than I care about you, I do not want to be around you, You are in the way, You are a bother, You should be seen but not heard, You can’t do that, You could have done better, You will never amount to anything, Don’t cry, etc. Step 4. Write down things you needed or wanted parents to say to you as a child. Here you can write the things you wanted or needed parents to say or do such as: I love you no matter what happens, I am so glad you are in my life, You can succeed, It's OK to cry when you're hurt, Everything will be OK, I felt the same as you sometimes, Imagine the possibilities. You are good at that, You are so helpful, You are so kind and caring, etc. Step 5. Write down what you would do or say if you saw another child being treated the way you were treated in #3. If you heard someone say mean things to a child or slap a child, what would you say? Maybe you would say things like: You have no right to say that, Be nice to the child, The child needs your love, You need to support your child and be reassuring and caring and loving and affectionate, You need to be encouraging, etc. Step 6. If you had all the positive things as a child that you needed from healthy parents, how do you imagine your life might be different today? If your parents had said encouraging, caring, and supportive things to you as a child, how do you imagine your life might be different today? This step helps you formulate and create a vision for how your life can be different in a healthy way. Depression that comes from negative self-talk is a form of self57
abandonment and self-abuse. The ultimate self-abuse and selfabandonment is self-harm and suicidal thinking. Conversely, hope, optimism, self-worth, and self-confidence form the basis of a stable mood and sense of security, safety, confidence, well-being, inner peace, personal power, and happiness. Step 7. Now you must be for yourself all the things that you needed your parents to be for you: encouraging, nurturing, loving, caring, supportive, and reassuring. This means you need to say to yourself and be for yourself all the positive things you needed from healthy parents. If no one else can give you the caring that you need, who does that leave? Ultimately, you are the one who must care for you. So this means you must choose healthy people to be in your life, and you must be supportive of yourself and of that other healthy caring person you have chosen to be in your life. In this way you will be caring of yourself. Another important piece is to stand up for yourself and support yourself when you are treated badly by others. Step 8. You must be assertive. Stand up for yourself by saying things like: I don't like your tone, I deserve more respect than that, I deserve a raise in salary, I feel annoyed when...., etc. Take care of that little boy or girl who was abused and mistreated. That little boy or girl is still inside you and needs your protection. Be for yourself now what you needed then as a child. Will you stand up for him or her? When will you start? The Angel View When depressed some years ago because of a painful loss, I was sinking and stuck in despair. Then I thought that the angels are watching, looking down from above, and able to see my life from beginning to end. They can see the valleys and mountains of my life, and they are wondering how I will face the present 58
challenge. Will I be stopped and give up, defeated? Or will I move forward and on to the next challenge? On realizing this and seeing my life from beginning to end, I understood that life is an adventure with obstacles and opportunities, mountains and valleys. I concluded that my life will change if I can persevere. I saw that the sense of loss and depression were only temporary and that other challenges await. When I saw the angel view, my depression lifted, and I felt free to go forward in my life knowing that I am able to move through the momentary difficulties and challenges of life.
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About the Author Daniel Keeran, MSW, has been a counselor and therapist for over 30 years in hospital and private practice settings. He is the author of Effective Counseling Skills: the practical wording of therapeutic statements and processes, and the founder and President of the College of Mental Health Counseling providing practical online skill training in counseling, for personal and professional development.
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