The Self-Directed Daily Inventory

It is tempting to think that a "good" or "bad" day results from a single event. Although a particularly wonderful event can buoy one’s spirits or an equally upsetting experience result in sadness or emotional upset, most days tend to be typical, the result of a series of events or experiences…some “good” and some “not so good.”

Individual events that become the exclusive focus of one’s attention can impact we evaluate a given day. When assessing a given day as “good” or “bad,” considering an isolated event or series of events restricted to a narrow focus of experience during that day can result in frustration if not depression. This is especially likely if several such “bad days” occur in a row. Such experiences foster what professional counselors and therapists refer to as “negative self-talk” or what those familiar with A.A. call, stinkin’ thinkin’.

The purpose of the exercise outlined here is to increase the likelihood of considering the “big picture” when evaluating a typical day. The Self-Directed Daily Inventory (SDI) is a daily activity designed to help one slow down their thinking, step back to consider multiple variables that affect mood, and look at the “big picture.” In doing so, it is possible to realize that things are not always the way they appear to be when considering just a “snapshot” of events in one’s day to evaluate it.

When employing the SDI, identifying specific categories of experience that YOU view as important in evaluating your day and then considering them independently to assess how “good” or “bad” your day was in each of those categories provides a more objective and therefore accurate assessment of one’s true experience. Using a set of evaluating criteria you establish for each of these categories facilitates this “stepping back” to consider the bigger picture. For example, identifying a minimum of five and a maximum of seven key assessment categories you deem important areas in your life and then evaluating your day in each category provides a more realistic overview of that day. Averaging the individual scores assessed for each of these 5 to 7 critical areas then yields a more accurate “score” regarding the day.

Specifically, use a simple “1 to 5” scale to evaluate each category. Describe the criteria that denote the lower and upper ends of this scale for each category with conditions or experiences you believe describe “bad” or “good” for that category. Next, total the scores for each category, find the average score (the total of all daily scores divided by the number of scores), and post this average on a graph to view progress or “change” on a daily basis.

This simple technique “forces” consideration of the “big picture” when determining progress or improvement in regaining personal control in one’s life.

To create your own step-by-step set of instructions, using 7 sample categories. You will need to choose your own important life categories and define the scale used for evaluation for this exercise to be effective. You can find a sample set of worksheets and instructions at https://tinyurl.com/S-DDaily-inventory

3rd Person Self-Talk and Self-Directed Behavior Change; How to Talk Sense to Yourself

Has a friend or family member ever approached you seeking advice on how best to deal with a personal issue or approach an important personal decision? If you are like most humans, the answer is yes. And when approached, were you able to proffer an opinion or provide the requested advice? Again, the answer is likely yes. This is because most of us are relatively good in such situations because we view ourselves as “detached” from the situation. Because of this detachment, we are more objective and offer reasoned advice.

 

Ethan Kross, a psychologist at the University of Michigan, has published research that finds that when individuals conduct their self-talk in the 3^rd person, that is referring to themselves by 1^st name or as he/she, him/her we can achieve that same degree of psychological detachment that enables us to provide more logical and rational advice to ourselves. Consider this example:

 

Instead of thinking, I can lose the weight needed to look good on the beach this summer, I say to myself, Robert, you can lose the weight needed to look good on the beach this summer.

 

Thinking in the 1^st person is a habit that is difficult to break. Why? Because we have likely been doing it for decades! However, when finding myself thinking in the 1^st person, I can “translate” those thoughts into the 3^rd person easily by simply inserting a 3^rd person pronoun or my first name, a nickname I go by, or my last name if that is how others generally refer to me – think “Gibbs” on NCIS – and create that psychological detachment that brings added clarity, reason, and logic to my thinking.

 

This can be a very helpful aid to accomplishing self-directed behavior change. Engaging in 3^rd-person self-talk about losing weight, quitting smoking, drinking less, or exercising more can help prevent self-doubt from derailing a change plan.

 

Before dismissing this idea by saying you do not want to sound like Dobby the House Elf in Harry Potter, remember we are talking about "self-talk" here...that is $10 psychobabble for "private personal thoughts," the ones no one hears except you :)

 

Robert – remember that willpower is a skill that you develop with practice rather than, I don’t have the willpower necessary to succeed; I’ll never be able to change.

Change is an inside job, Robert; one that you can accomplish because it is more about attitude than effort rather than, Change is just too hard for me; I will never be able to do this.

 

What do you think?

 

To read more about 3^rd-person self-talk as an aid in stress management, ending negative self-talk, or quietening anxiety, CLICK HERE.

 

Dr. Robert

What We Need to Understand About Willpower

Willpower is arguably a social construction that we humans have conjured up to explain why some are successful in controlling their behavior while others are not -- For those who do, we say they “have willpower” while those who do not, don’t. 

What is willpower but a means by which we choose to measure our ability to control ourselves and/or our

environment. This preoccupation with control, especially when measured regarding our ability to regulate our personal behavior, lends itself to a binomial consideration of success…we either succeed or fail in exercising that control. However, it is just this point…viewing willpower as an ability one either possesses or not…that results in self-defeating beliefs when struggling with efforts to self-direct behavior change. But what if willpower is not so much an ability one either has or does not have, like a biological trait genetically passed along by birth parents, but a skill capable of development like any other?

The first step in developing this skill of self-regulation is identifying the specific details associated with the behavior I am trying to regulate. If, for example, I “drink too much” and have come to the realization that I have a “drinking problem,” then the behavior I am trying to regulate is my drinking and my objective is to drink less if not quit altogether. Although “not drinking” may seem the obvious objective, until and unless I understand the details associated with my issue, I am likely to think that the only option available to meet my quit-objective is to “will myself” to “not do it,” the white-knuckle approach to change if you will. With willpower as my perceived only approach to change, I assign the responsibility for my success to a supposed character trait, one that I may or may not have. In short, viewing willpower as a trait relegates my ability to change to the genes I inherited from my biological parents, which makes the likelihood of my success little more than a crapshoot. But is this an accurate assessment of how people change? Are only “some of us” destined to change our behavior should we wish to do so?

And what if “willpower” is a skill rather than a trait? A skill, like any other, capable of development over time through practice. By attending to the details of my behavior, for example, my drinking, I can identify important clues that affect my ability to change it…or change my gambling habit, or failure to take my medication, or “whatever” it is I seek to change. If what-causes-a-problem-is-a-problem-when-it-causes-a-problem, then the more I know about “it,” the better prepared I am to make appropriate behavioral changes that support my ultimate change objective. When I do “it,” where I do “it,” with whom I do “it,” etc. This is consistent with viewing willpower as a skill that I develop. Like the old joke about the visitor to N. Y. City when asking the maestro, “How do I get to Carnegie Hall” gets the reply, “Practice, practice, practice,” the will to change is as much a skill that one develops as it is a personal desire to alter one’s behavior.

The more I know about “my habit” or the pattern of behavior I wish to change, the better prepared I am to address it. And when I do decide to address it, I am choosing to act on that behavior rather than react to it. This means my success in changing my behavior has more to do with the steps I take that support that change than the amount of willpower I may or may not have been born with. In short, as a skill, willpower is something developed, strengthened, controlled, and then, directed.

Motivating Physicians to View Treating Addictions Differently

I suspect that an important part of having an impact on an audience composed of medical students and physicians is being able to invite them to see beyond any individual case of effective treatment, e.g., "the case of Brad," and focus on a more generic patient with an addictive disorder. They will all know of or at least heard of patients who “quit.” For them to become motivated to consider doing something different, however, they are going to have to see beyond "Brad" and recognize that “these patients,” that is, "addicted patients," can change and the way they change is by my doing “more of this” and “less of that.” This is the challenge I believe we face when inviting physicians to rethink the treatment of patients with addictive disorders. I suspect physicians may be more motivated to consider changes in their treatment strategies if seeing the “The case of Brad” as the result of an effective process to which "Brad" responded rather than something idiosyncratic about him as an individual that resulted in, for lack of a better term, a spontaneous remission.

When presented with the opportunity to speak with physicians or medical students, my goal is to impress upon at least some in the audience that: (1) change is an inside job, i.e., “physicians do not change patients (at least those with addictive disorders), but patients change patients,” and (2) the physician’s job with addicted patients is almost counter intuitive when considering what physicians generally do when treating “real” diseases. Historically, physicians conduct a differential diagnosis, prescribe a course of medical treatment, administer that treatment, follow-up on that treatment, and then discharge the patient...end of story. At best, the patient is a passive participant in the change process. With addictive disorders, however, nothing changes until and unless the patient makes that internal decision—choice, if you will, to change...the “inside job” mentioned earlier. Basic factors in the “keys to success” when treating an addictive disorder are: (1) recognizing that the addicted individual has progressed from a pre-contemplative stage of readiness to change to an action stage and eventually on to a maintenance stage, and (2) this happened because the individual realized he or she wanted to change rather than felt obligated or manipulated or forced to do so...again, the “inside job.”

I do not believe that the way to motivate physicians to think about treating addiction differently is to charm them into doing medicine with addicts differently—they will have 100 examples of how treatment does not work and even more reasons why this is so. Rather, it is to present them with a way to lessen their personal frustration when working with addicted patients. Put another way, we cannot push them into treating addicted patients differently, but we might be able to lure them into reducing their personal frustration when interacting with such a patient. It is sort of like Tom Sawyer getting his buddy to paint Aunt Polly’s fence...he entices the buddy to want to have the experience rather than talk him into doing his work for him.

As Sandra Anise Barnes has suggested in her poetry, "It is so hard when I have to (change), and so easy when I want to."

What do you think?

Robert

Seeing What You Expect to See

Stephen King once said in an interview, "Belief is the wellspring of myth and imagination." When I came to this quote while reading a book on brief therapy, in particular the sections on constructivism and narrative therapy, I could not help but think of the way contemporary collegians look at alcohol as a substance and drinking it as a behavior.

Alcohol and its consumption have become significant icons of collegiate life and a mythology surrounding drinking has evolved that is so entrenched in the minds of students entering college--not to mention their parents who recall its role from their college days--as to resist even the latest efforts to address the misperceptions many hold regarding it.

Alcohol and drinking have meaning because we ascribe that meaning to these icons of contemporary collegiate life. Michael Hoyt in (Some Stories are Better than Others: Doing what Works in Brief Therapy and Managed Care (2000) suggests that the essence of being human is that we are "meaning makers" and by our very nature cannot not participate in explaining, by whatever means, that which we experience. This is an apt explanation of how meaning is ascribed to alcohol and drinking...those who are aware of these aspects of college life maintain that awareness in the context of the meaning they have attributed to them. Unfortunately, the meaning we ascribe to an event in order to explain and understand it is does not guarantee its accuracy, hence the role of myth in explaining all manner of natural events and phenomenon.

For example, when I understand that alcohol is a prerequisite of "having a good time," it quickly becomes synonymous with having that good time. In fact, the mention of alcohol is no longer required because the party itself has become imbued with the meaning that alcohol will be present and those attending will be consuming it. Interestingly, the noun becomes a verb, which itself is a euphemism for drinking, that is to say, "to party" mean to drink.

Although this meaning is not isolated to collegiate life--many in high school have already become familiar with alcohol and understand its importance in a successful social life--it changes as students progress through successive terms in their collegiate experience. The meaning attributed to alcohol as a substance and drinking as a behavior "change." Where first-year students expect and then seek out the collegiate "keg party" with its obligatory "drinking games" and related "drunken comportment," the lure of this type of past time lessens.

In research that I have conducted the meaning ascribed to alcohol and drinking changed significantly as students progressed from their first-year to their later years in college--see my second monograph on collegiate drinking for an in depth look at this phenomenon - http://www.community.rowancas.org/Monographs/Monograph_510.pdf. It would appear that the meaning students ascribe to these collegiate icons changes as the result of experiences they have with them, either personally or vicariously--or more likely both. Whether this is a result of developmental movement from adolescence to young adult with the accompanying development of one's ability to reason with the further physiological development of the prefrontal cortex of the brain or whether it is learned through progressive experiences where drunken comportment becomes less attractive, the point remains, the behavior of many (most?) collegians who choose to drink in a high-risk fashion changes.

What is of interest to me, as a professional interested in issues of prevention and intervention, is how this naturally occurring process can be better understood and then incorporated into contemporary approaches to preventing untoward consequences associated with drinking. It stands to reason that if collegiate drinkers "mature out" of their high-risk approaches and this happens because the meaning hey ascribe to alcohol as a substance and drinking as a behavior have changed, then if we can understand this process we can likely hasten this process.

I suspect this is the next chapter that will need to be written in the handbook on preventing high-risk and dangerous drinking.

Taking the Risk to Change

My 6-year-old grandson called the other evening. “Poppy,” he asked, “...when you were a boy, did they have furniture?” I was somewhat taken aback, in part by the unexpected question and mostly because of having been presented with one of those moments I believe John Lennon referred to when he said during an interview, “Life is what happens while you are busy making plans.” I was mowing the lawn and felt the phone vibrate in my pocket and stopped to answer, certainly not expecting anything quite like this question.

Apparently, my grandson had been talking with his father and had asked him this question. My son-in-law—in part recognizing the humor in the question and knowing that I would appreciate it—and in part recognizing its innocence and simple beauty, suggested that his son call his grandfather and ask him the question directly. Bobby—named after his dad who was named after his dad, making him “the third”--called, dialing the phone by himself and posing his question to his grandfather directly. I assured him that indeed, furniture was invented long before his grandfather had been a boy, but found myself marveling at the significance of this question after we ended our conversation. The more I considered our brief conversation the more I realized that my grandson was beginning to ask questions about what he thinks about the world in which he lives. It then occurred to me how similar this may be to the experience of individuals with whom I have worked in counseling over the past 35+ years.

Like my grandson, individuals in counseling begin to experience change when we they feel safe enough to ask questions about what they believe are the facts in their lives, what they think and believe if you will, and do so without fear of retribution. “Change,” as I once heard said at an AA meeting, “...is an inside job.” But this change only occurs when one is able to see life—the “facts” if you will—from a new perspective. I can then choose to move from where I am to where I now want to be, based on my new perspective. To gain that new perspective, one often must take risks, most notably the move from a place of comfort to one at best unknown and often potentially unsettling. Before one can take that risk two things have to happen. First, I must become aware that what I think may not be all there is to be known on a given topic. Second, I must find a way to explore what there is to be known about the topic in question, a.k.a., "the world," and here in lies the “quest” in asking the the “question.”

My grandson truly believed that his grandfather predated the invention of furniture. This is not such an odd question for a six-year-old to ask...my grandfather was six in 1903 when the Wright Brothers first flew. I could have asked him, “Poppy"--I called my grandfather Poppy too--"Did they have airplanes when you were a boy?” The questions we ask are not as important as feeling safe enough to take the risk of asking them. It is likely that no two individuals see the world through the same set of lenses...we all have our own unique prescription. What is important is feeling safe enough to ask our questions and encouraged to pursue the development of new information on which to base our choices and decisions as regards how to live our lives.

My grandson now knows just a little bit more about his life...at least how his view of that life comes to make sense to him in the context of the “big picture.” But he has taken that tiny step forward because he was encouraged by his dad to, “ask Poppy,” and when he did, he was able to get an answer from Poppy. The funny thing is that while he is likely clueless of how significant that experience was in his development as a person, his grandfather could only marvel at its significance...and how like professional counseling in that it is only when someone feels safe enough to ask the spontaneous question that the opportunity for growth is presented.

When I apply this personal life experience to my work as an educator I wonder how do we who are just a bit further along the road of discovery in life encourage those who follow us to appreciate the journey? How do we who encounter those who believe they “know it all” to explore what they know in order to discover there is more? As my grandfather used to tell me, “Wisdom is the gift received when recognizing the limits of one’s knowledge.”

(NOTE: For a musical treat listen to Dan Foggleburg’s “The Higher I Climb” cut from his High Country Snow CD – see lyrics at the bottom on my web page, http://www.robertchapman.net/home1.htm )

Responding to Resistance

In the introduction to Chapter 8, "Responding to Resistance" (p. 98) of Miller & Rollnick's Motivational Interviewing, 2nd Edition (2002)--and please note that this is a text that addresses alcohol and other substance abuse specifically, but I sense that its principles are applicable across the counseling spectrum--the authors suggest that some practitioners view resistance to therapy as something inherent in the client's character if not indicative of a presenting problem such as alcohol or other drug dependence, symptomatic, if you will, of the disorder to be treated. They argue that attributing client resistance to an inherent personality characteristic may be something of an erroneous assumption. This may be particularly apropos if the counselor's perception of client resistance is viewed as a clinical defense mechanism and the denial of "the problem" that must be breached if therapy is to progress. Miller & Rollnick suggest instead that resistance, "...to a significant extent, arises from the interpersonal interaction between counselor and client."

I found this argument provocative in light of my long standing problem with the traditional, "kick in the front door" S.W.A.T. team approach to "confronting" client denial and "breaking down" resistance to treatment as the prerequisite to change for addicted clients. These clients, presenting in what Prochaska would refer to as a "precontemplative" stage of readiness to change, are likely to be steeled in their resolve to resist what they must see as "attack therapy" with treatment offered by counselors that seem to suggest that, "addiction is the problem" and "my way or the highway" is the answer. As early as 1973 Lieberman, Yalom, & Miles (Encounter Groups: First Facts, NY: Basic Books) suggested that confrontational group therapy was likely to result in more harmful and adverse outcomes in therapy than alternative approaches. If the first order of clinical business for a practicing counselor or therapist is to "do not harm," then avoiding an iatrogenic result of that counseling may be what Miller and Rollnick are addressing in their argument that resistance is a result of interpersonal dynamics in a session rather than client pathology.

My grandfather used to say that you do not remove a hornet's nest on the porch by beating it with a stick. I am wondering if this was not a layman's equivalent to Miller and Rollnick's argument suggesting that resistance arises more from the interaction between client and practitioner than the pathology of the client...the bees were likely not resisting until the first blow from the stick

You can read more on "Motivational Interviewing" and "Stages of Readiness to Change" at my website, http://www.robertchapman.net...click "Treating Addictions" in the menu

Robert J. Chapman, PhD

http://www.robertchapman.net
LinkedIn profile: http://www.linkedin.com/in/rjchapman