084: Role-Play Techniques (Part 2) — Paradoxical Double-Standard Technique

The is the second podcast on TEAM-CBT role-playing techniques and features the Paradoxical Double Standard Technique. David describes watching Dr. Maxy Maultsby do a demonstration of the Double Standard Technique when he was a psychiatric resident in the 1970s at the University of Pennsylvania medical school. He was quite surprised when the patient, who was severely depressed and suicidal following a break-up with her boyfriend, improved dramatically within an hour. David modified the technique in several ways, and tonight will present what is probably the most powerful way to use this technique.

The technique is based on the idea that most of us operate on a double-standard. When we are upset about some failure, mistake, or inadequacy, we tend to beat up on ourselves mercilessly. But if we were talking to a dear friend with the exact same problem, we’d be far more compassionate and realistic. Once you make the patient aware of this double-standard, you ask if he or she would be willing to talk to himself or herself in the same way he or she would talk to a dear friend.

But the unique feature of the way David does it, is that you, the therapist, “become” a dear friend of the patient, kind of like a long-list identical twin who is actually virtually identical to the patient, but a different person. Then the therapist (playing the role of the friend) describe the problem the patient is struggling as if it is your own problem.

Then you ask the patient what he or she thinks. Typically, the patient will respond with great compassion. Then you, the therapist, cross examine the patient, to make sure what the patient is saying is the absolute, 100% truth. Finally, you ask the patient to record this in the Positive Thoughts column on his or her Daily Mood Log.

While no technique will work for everyone, this one works for many patients if:

  1. You’ve done excellent Empathy first.
  2. You’ve done skillful Paradoxical Agenda Setting to melt away the patient’s Outcome Resistance.
  3. The patient is reasonably compassionate and actually does have a double standard. On rare occasions, you may have a patient who hates himself or herself, who also hates other people. For these patients, the technique will not be effective.

The special guest tonight is Eleanor Scott, a community therapist who is a student in David’s Tuesday group at Stanford, and who has bravely volunteered to help demonstrate teaching techniques once again. (Eleanor was also feature in an Empathy role-play a couple weeks ago.)

Eleanor has brought a partially completed Daily Mood Log to the group, and the Upsetting Event is simply being in the Tuesday group and feeling insecure while trying to learn TEAM-CBT. These feelings are a fairly common, almost universal, among the therapists who attend David’s training groups. Initially, nearly all of them feel intense anxiety, along with a myriad of other negative feelings, such as shame and inadequacy, due to the belief that they are not “good enough,” along with the fear that others in the training group will notice their ineptitude and judge them!

Eleanor’s Negative Thoughts included:

  • I should be learning more quickly.
  • The other students will notice that I don’t know what I’m doing!
  • I’m never going to get this.
  • I don’t know what I’m doing.
  • I sound like an idiot/stupid.
  • I suck!

David explains how the Paradoxical Double-Standard Technique works, and demonstrates it with Eleanor. Eleanor finds a powerful inner voice and quickly blasts all of her Negative Thoughts out of the water.

David cross-examines Eleanor to find out if this amazingly rapid and dramatic change in her Negative Thoughts and feelings was real, or if she was just being “nice” to try to produce a good role-play for David!

Fabrice raps up the podcast with his (as usual) great interview with David and Eleanor, bringing out many of the teaching points during the session.

Follow-up: The day after the recording, Eleanor sent this fantastic email to our training group, and she gave me permission to share it with all of you.

Hi Tuesday groupers,

I wanted to share a success that I had with everyone, especially my ‘newbie’ group.  I received a low grade on an evaluation of a therapy session by a client last week, and I started the session today by discussing this with the client.  I used the Five Secrets of Effective Communication to acknowledge that she wasn’t heard (Disarming Technique) and shared how I felt about the session (“I Feel” Statement). I also asked about what I had missed (Inquiry). Throughout her account, I used Thought and Feeling Empathy.

The connection that was created from this was incredible.  I was able to truly see this client and hear her story and see the amazing grace with which she lives her life (Stroking).

I also think that I was able to truly be present and vulnerable with my client had a lot to do with the amazing work I experienced being a volunteer on the podcast last night.  I can’t thank you enough David… I am STILL feeling good and I’m riding this good feeling as far as it takes me!

If you get a chance… volunteer for the podcasts… it’s such an incredible opportunity for growth!

Thanks,

Eleanor

David’s response: Wow! Way to go, Eleanor! Awesome!

Next week: More of David’s Role-Playing Techniques!

Coming VERY Soon! Advanced, High-Speed TEAM-CBT for the Treatment of Depression and Anxiety 

We warmly invite you to attend this fabulous, one-day workshop by Drs. David Burns and Jill Levitt on Sunday, May 20th, 2018. Click on the link above for registration and more information.

  • 6 CE Credits
  • The cost is $135
  • You can join in person or online from wherever you live!

You will enjoy learning from David and Jill, working together to bring powerful, healing techniques to life in a clear, step-by-step way. Their teaching style as a team is entertaining, funny, lucid, and inspiring. This is a day you will remember fondly!

In the afternoon, you will have the chance to do some personal healing so you can overcome your own feelings of insecurity and self-doubt. David and Jill promise to bring at least 60% of the audience into a state of spiritual and psychological enlightenment, WITHOUT years of meditation. That’s not a bad deal at all!

You will LOVE this workshop. Seating for those who attend live in Palo Alto will be strictly limited, and seats are filling up fast, so move rapidly if you are interested.

Jill and I hope you can join us!

Fabrice and I hope you like our Feeling Good Podcasts, and also hope you can leave some positive comments for us and five star ratings if you like what we’re doing!

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At least one listener has had problems leaving an iTunes review from his i-phone, so Fabrice has created some simple to follow instructions if you need help.

 

 

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