Liivis practices a new technique in therapy called the Externalization of Voices. The therapist speaks using Liivis's negative thoughts while Liivis speaks using her positive thoughts. The therapist attacks while Liivis defends; they switch roles if Liivis gets stuck.
Liivis Talks Back to Herself
Robert Davies (C) 2019
“Good morning Liivis.”
“Good morning, Bob.”
“Ready to do the Liivis vs Liivis.”
“I sure am. You have me curious.”
“I'll explain. First, take the last mood log we worked on.”
“The one about relapsing back to smoking marijuana?”
“That’s the one, Liivis.”
“Let’s see you had the following negative thoughts:
I shouldn’t have done this to myself
I let everyone down.
I could become an addict again.
I did all this hard work for nothing.
I don’t have the will power anymore.
I’m an idiot.
“This is how it works. You and I will take turns playing the role of your thoughts. I will play your negative thoughts, and you will play the role of your positive thoughts. You can use what you have learned about the 10 cognitive distortions, too“ (See 10 Cognitive Distortions at end of story.)
“Got that, Liivis?”
“I think so. You are the negative me, and I am the positive me. I defend myself against your negative distortions.”
“Exactly, I will start as the Negative Liivis, and you will start as the positive Liivis. If you get stuck, we will reverse the roles.”
“Are you with me?”
“I think so?”
“Okay, who are you?”
“I’m Liivis.”
“Who am I?”
“Who are you?”
“Yes, remember I am your negative thoughts so I must be …?”
“Liivis. Negative Liivis.”
“Right! And you are Positive Liivis.”
“Okay, let me start. I attack. You defend.”
Negative Liivis (NL): You shouldn’t have done this to yourself. You are always screwing up. This means things will turn out badly. You are a loser and it is all your fault.
Positive Liivis (PL): That is an invalid ‘should’ statement. I had a relapse. In fact, all addicts are expected to have at least one relapse. To say, I am always screwing up is all-or-nothing thinking. I do make mistakes. In fact, my work record shows that I have 90% excelled with only about 10% needing improvement. In my books, that is pretty good. Calling me a loser is labeling. There is no such thing as a loser because nobody loses all the time. They win, too. And about it being my fault. Well, yes, I own my part. But a lot of it belongs to my supposedly ‘good friends’ who introduced me into the habit as well as the new government that made it sound so worry-free by legalizing it and then promoting it through companies from which it hopes to get tax revenue. Oh, no Ms. Negative Liivis, you cannot pin that thought on me!”
“Stop. Well, Liivis. Who won?”
“I did.”.
“Big or small?”
“Big.”
"Big or Huge?"
"Huge."
“You are so right!”
“Okay, let’s do the next thought.”
NL: You could become an addict again. That’s how it starts. One fall and you’re lost once again to your addiction. Deep down, you really do want to keep the habit. It’s a big mistake, very big. You are a born addict!”
PL: Listen, I relapsed once. It is expected in case you have forgotten. There are lots of successful cases, almost all in fact, where there was a relapse. You are blowing things way out of proportion. You are also consumed with negativity. I was clean for six weeks before I relapsed once. That is one day out of 42 days or 2% failure for the time period. Also, I do a ‘cravings score’ when I attend my therapy sessions, and the urge to take the drug has dropped from 100% strong to 0% strong. Now that is something!
“Stop. Okay, who won?”
“I did. Small or big?”
“Big.”
"Big or huge?"
"Huge!"
“Right you are!”
“Okay, next thought. You do it. Choose anyone.”
“Number 5 – You don’t have the will power anymore.”
Liivis plays Negative Liivis.
Negative Liivis: Liivis, you don’t have the will power anymore. You really messed up going back to the marijuana again. You will always be hooked. It feels good so you believe it must be good. Here you did all that work with Mr. Jenkins, the therapist, plus support from the addictions program from the province, and you still slipped up. No will power. You are so in love with that weed that you can expect to keep falling back into the addiction. You might as well throw the towel in and be honest with yourself.”
Positive Liivis: Well, that is all-or-nothing-thinking. I succeeded 98% of the time not taking the drug. That means ‘sometimes’ not always. And I have proof that I won’t ‘always’ be hooked in that I remained drug-free 98% of the time. That shows determination. That shows real will power. I didn’t slip up or back or whatever you want to label it. I had a relapse, which all addicts have. The very next day, I was back with my regime. I am a success in my program say the instructors, and my therapist shows me every day that I am succeeding in reducing anxiety, anger, and depression. Also, my cravings measurements show them to be way down. In conclusion, Ms. Negativity! I have very much reduced all my negative emotions, and I have brought my cravings from 100% strong to 0%. That is real success!”
“Stop. Who won?”
“The positive Liivis won.”
“Big or small?”
“Big!”
"Big or huge?"
"Huge!"
“Great work, Liivis. Let’s continue. You go back to the Positive Liivis.”
Bob, the counselor, uses this technique called Externalization of the Voices. First, Bob works with the client to identify all the emotions attached to the situation - relapsing. Then he helps client identify the thoughts that cause these emotions using again the mood log. The therapist gets the client to identify the cognitive distortions in each thought, such as All-or-Nothing Thinking, Overgeneralization , Mental Filter, Discounting the Positive, Fortune-Telling, Magnification and Minimization, Emotional Reasoning, Should Statements, and Self-Blame.
As David Burns MD, the creator of TEAM CBT Therapy would explain: Liivis fairly quickly knocked the ball out of the park, and easily crushed the Negative Thought with which Bob had attacked her. Then Bob attacked Liivis with the rest of her Negative Thoughts, one at a time, doing occasional role-reversals to illustrate different ways to attack the thought. They continue doing role-reversals when necessary until Sarah described her victory over each Negative Thought as “huge.”
END
NB See Cannibis Caveat: Part 4 Fighting Anxiety
Positive and Negative Cognitive Distortions about Marijuana
All-or-nothing thinking. You think of everything wonderful about marijuana or everything not so wonderful without it. You refuse to look at anything in between that might not be so wonderful.
Overgeneralization. You take one single event, getting high and you generalize it to your entire life, making your life entirely wonderful because of it.
Mental filter. You dwell on the positives about marijuana, and you ignore the negatives.
Discounting reality. You ignore any negative facts about marijuana of which there are plenty.
Jumping to conclusions. You jump to conclusions not warranted by the facts.
Mind-reading. You believe you know what people are thinking.
Magnification or minimization. You minimize the negative consequences of marijuana, or you blow the positives way out of proportion.
Emotional reasoning. You reason from your feelings. “I feel good smoking up; therefore, smoking up is good for me.
Should statements. You make rules about marijuana addiction that aren't really rules.
a) Self-Directed “shoulds” cause feelings of guilt, shame, depression, and worthlessness – I should never have started!
b) Other-Directed “should” cause feelings of anger and trigger interpersonal conflict – My friends should never have encouraged me!
c) World-Directed “shoulds” cause feelings of frustration and entitlement. I should be able to control my consumption of marijuana. Canada should never have made it legal.
Labeling. Instead of saying: I made a mistake, you say “I am a mistake”. Instead of saying I did something idiotic, you tell yourself, "I' m an idiot!"
Self-blame and other-blame.
a) Self-blame. You blame yourself for entirely for your bad habit, forgetting others might have contributed to your addiction such a the government making it legal and selling it, making it readily accessible.
b) Other-blame. You blame others for your bad drug habit and overlook ways that you contributed to the problem.