I’ve been posting on the power of Cognitive-Behavioral Therapy (CBT) when properly and faithfully applied to help ameliorate a variety of problematic psychological conditions (See also: A Primer on Cognitive-Behavioral Therapy and Cognitive-Behavioral Therapy Primer – Pt. 2). CBT is an especially helpful approach in dealing with character disturbance but it’s also proven its worth in many other areas including anxiety disorders and anxiety-related conditions, trauma recovery, mood disturbances, and impulse control problems. But as I have noted previously, it’s not uncommon for the most important part of the CBT paradigm (i.e. the behavioral component) to be afforded less than optimal or even no attention. As I have asserted many times, genuine change always occurs in the here-and-now moment, and for change to be properly promoted and reinforced, problem behaviors must be reckoned with at the very moment they occur. Toward that end, over the years I developed worksheets that both individuals with character impairments and their relationship partners have used to confront and correct dysfunctional behaviors, thinking patterns, and attitudes (These behaviors, thinking patterns, and attitudes are also outlined in my books In Sheep’s Clothing and Character Disturbance, and to a certain extent, in The Judas Syndrome). I developed two versions of each worksheet, one to assist the person with the thinking errors and problem behaviors both spot and self-correct them and another to assist a relationship partner with recognizing and calling out these dysfunctional habits.
To give you an example of how both problematic behavior and thinking patterns are targeted with CBT, here are some excerpts from the worksheets fashioned for persons with character impairments:
From the worksheet on Thinking Errors:
ERRORS IN THINKING
Adapted from the work of Stanton Samenow, Ph.D. and modified and expanded on
George Simon, Ph.D. (Latest revision: 03-15-06)
NOTE: There are many erroneous or problematic ways to think. These are just some of the more common thinking errors.
1. EGOCENTRIC THINKING. Thinking only about myself and what I want. Thinking that the world revolves around me. Not thinking about others or whether what I want is really right, good, legal, or might hurt someone. This kind of thinking promotes a self-centered attitude and a disregard of my social obligations.
6. DECEPTIVE (WISHFUL) THINKING. Seeing things as I want to see them, rather than as they are. Lying to myself and trying to hoodwink others so I don’t have to take an honest look at things. Distorting the reality of situations so I don’t have to change my point of view or ways of doing things. This way of thinking causes me to live in a world of my own fantasies and promotes an attitude of disregard for the truth.
8, EGOMANIACAL THINKING. Thinking I’m so clever, important, or bright that I can and should do whatever I please and get away with it. Thinking I’m so special that I am entitled to have whatever I want just because I want it. Thinking the world owes me because I am special and important, rather than being willing to earn the things I value. This way of thinking promotes attitudes of arrogance, superiority, and especially, entitlement.
And from the worksheet on problem behaviors:
Behaviors that Obstruct the Internalization of Behavioral Standards and Controls and are often Used as Tactics to Manipulate Others
George Simon, Ph.D. (Revised 1-28-11)
NOTE: There are many tactics a person can use to manipulate others and resist accepting responsibility. These are some of the more common ones.
1. Rationalization. Attempting to justify a behavior or make an excuse for it despite knowing that most people would agree it is inappropriate, harmful, or wrong. Having an answer for everything, so that when others confront a problem behavior on my part, they might begin to doubt the legitimacy of their concern. Trying to get others to “buy into” my excuses so they can be manipulated into backing-off or backing-down. Telling myself that what I really know is wrong is okay, so that I have false justification to do it again.
4. Minimizing. This is when I make a molehill out of a mountain. It’s when I try to convince myself or others that whatever I did wasn’t really that bad or harmful. It’s also when I admit only part of what I did wrong, and usually not the most serious part. Sometimes this is a tactic to make others think I’m not such a bad person. Sometimes it’s the way I keep myself from admitting the full extent of my character or behavior problems. If I keep minimizing, I certainly won’t take seriously the problems I need to correct.
10. Giving Assent. This is when I pretend I agree or pretend to give-in on an issue in order to get someone off my back. It’s when I say I’ll do something while I still know in my heart I don’t want to and probably won’t. It’s a tactic I use to disarm others while still actively resisting the standards or controls I know they want me to internalize.
Now, these are just a few selections from each worksheet. And the biggest reason I crafted the worksheets is that the responsibility for change rests truly with the person, not the therapist. At the outset, a fair-minded therapist might call to attention certain behaviors, tactics, and thinking patterns but eventually the issues of concern have to be self-monitored, self-caught, and self-corrected by the person who exhibits them. Providing someone a worksheet and reinforcing them for faithful practice (reinforcement being the most essential aspect of behavior therapy) is how good therapeutic “leverage” is maintained.
To the many out there who’ve written me to say they had experience with CBT but got no help: When’s the last time you can remember getting tools of a nature similar to this or being coached on how to use them to change dysfunctional patterns or to empower yourself?
In next week’s concluding article, I’ll provide some excerpts from the worksheets custom-crafted to help folks in a relationship with a disturbed character, are recovering from such a relationship, or have other issues of their own that CBT has been shown to be helpful in addressing.
This week’s Character Matters Program will again be a live broadcast, so call-ins can be taken.