032: Live Session (Mark) — Agenda Setting Phase (Part 4)

Part 4—A = Paradoxical Agenda Setting (PAS, cont’d

As the session continues, Jill and David encourage Mark to develop his list of positives. Mark draws a blank at first. This is very common among patients and therapists alike. Most of us have not been trained to think about depression, anxiety, shame, defectiveness, hopelessness and anger as being good or positive. In fact, we think of them as symptoms of “mental disorders,” according to the DSM (Diagnostic and Statistical Manual of the American Psychiatric Association.) So we think of them as bad, something to get rid of, something needing treatment.

IMG_1860But after David and Jill prime the pump, Mark is surprised that they quickly come up with a list of 16 positives that are real and powerful. At this point, they ask Mark why in the world he’d want to press the Magic Button and have all of his symptoms suddenly disappear–given all these positives. This is called the Acid Test and it’s also paradoxical. David and Jill have now become the resistant part of Mark’s subconscious mind–the part that clings to these symptoms. And when the therapists become the voice of the resistance, the patient will nearly always become the voice that argues for change.

The paradox is resolved with the Magic Dial. Toward the end of this podcast, you will want to review Mark’s Daily Mood Log, with the Goal column filled out on the table of negative emotions.

David points out that there is no single tool or technique that triggers recovery in patients. Instead, each component of T E A M contributes in radically different ways to the substantial or even dramatic improvement the therapists are hoping to bring about it today’s session.

In the next Podcast, David and Jill will begin the M = Methods portion of the session.

2 thoughts on “032: Live Session (Mark) — Agenda Setting Phase (Part 4)

  1. Hi David,

    Thanks to you, Fabrice and Jill for this episode – as with the previous episodes with Mark, this has really helped in bringing the TEAM approach to life.

    As I have been using your books in the past few years to self-treat feelings of anxiety/depression, I was very keen to hear how the new agenda setting step works.

    I am wondering what your thoughts are on how effectively the “A” step can be carried out by a patient on his/her own (ie. without someone else verbalising the reasons not to change / playing the part of the patient’s sub-conscious)? Do you have any tips? I think I heard Mark say something to the effect that, on his own, he wouldn’t have thought of all the positives that you came up with in the session.

    Thanks again for sharing these great tools and techniques – looking forward to the “M” step soon.

    Paul

    • Thank you Paul for your excellent and very thoughtful question. The answer is yes, and in fact, I believe that the “A” part of TEAM-CBT can be understood and implemented far more easily by the general pubic than by therapists. The problem with trying to teach therapists, and I apologize if I sound negative or a bit cynical, is that many therapists appear unteachable, since they are married to their own ideas and training, which they have to “unlearn” in order to learn TEAM-CBT. But many just don’t want to learn new and radically different approaches, for a variety of reasons, some of which are rather unflattering.

      So to be more positive, I have found that every “patient” I have worked with has quickly and deeply grasped the “A” of TEAM (A = Paradoxical Agenda Setting) and has welcomed the new approach, and benefited quite a lot. I will be writing a great deal more on this, but it is exciting to think about, since this opens up new vistas in what is called “bibliotherapy!” Thanks so much! I am pretty psyched!

      David

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