Fatima's Quest for Sleep & the 'What If' Technique
Updated: Mar 14, 2019
Turn. Turn. Turn. Thoughts keep turning around in Fatima's head. They keep her awake with negative thoughts: "what if that were to happen?" and if so, "what if that were to happen?" Then around and around again. Never stopping. Always turning. These can stop using the 'What If ' technique. Stop the turning, turning, turning.
Turn, Turn, Turn
Robert Davies © 2019
Robert Jenkins, the counselor was listening to a mother whose daughter had recently gone to the psychiatric unit at the local hospital to get support.
“Let me know if I have this right, Fatima. Since your daughter, Jacinta, has been an out-patient at the hospital. This has been a shock to you; nevertheless, she is making progress; and you are feeling better?”
“That’s right, Bob, I am managing much better now and can go about my work day without distraction.”
“So, Fatima, you’ve managed to adjust thanks to the therapy we have been doing?”
“Nevertheless, just at night when the family has gone to bed and you are all set to sleep, you can’t?”
“Your mind starts to spin, to turn from one thought to the next?”
“Yes, Bob, it happens when I am all alone.”
“Well, certainly, there’d be no distractions from the family or work day. You’d naturally start to think about your daughter.”
“Well, that’s the trouble. I don’t seem to be worrying exactly.”
“Well, is your mind ill-at-ease?”
“Yes, it is.”
“Well, I am thinking and correct me if I am wrong. You probably are thinking about your daughter. Now, we know she is getting help, and the whole family has managed to adjust.”
“Yes, we are making progress day-to-day.”
“So, Fatima, if the past and present is going along, slowly improving … by the way am I right there?”
“Well, Fatima, maybe it’s about the future? You mentioned that your daughter would be returning to university, maybe.”
“Yes, Bob, that is probably it. We have managed to settle things down with Jacinta. Now, I am concerned about ‘what next?”, about her future.”
“You are concerned about her future?”
“Yes, she is so fragile still but getting stronger. I guess I am thinking ‘what if’. What if this happens and what if that happens.”
“Fatima, let’s use the What If Technique.”
Bob reached for his binder and pulled out two identical sheets and handed one to Fatima.
“Okay, write down in the first box, the thought: Jacinta is fragile.”
Fatima wrote it down. Then Bob asked her, “How true does that seem to you?”
“Well, certainly 100%.”
“Fatima, write 100% True beside the sentence ‘Jacinta is fragile’ and then put a downward arrow under the sentence.
Jacinta is fragile
“Now, what’s the worst thing that could happen to Jacinta if that were true?”
“Well, Bob, I guess she’d start to make bad decisions.”
“And how true is that?”
“Okay write 70% beside that, Fatima, and then put a downward arrow under ‘Jacinta would start to make bad decisions.”
Jacinta is fragile
She will start to make bad decisions
Bob and Fatima continued with this line of questioning: what’s the worst thing that could happen to Jacinta if that were true?” and continuing to write the answer to this question until they had eight sentences in a row.
Jacinta is fragile
She will start to make bad decisions
Then she will take the wrong path.
Then she’ll start to form addictions.
Then Jacinta’s health, both mental and physical will be affected.
Then she will never be happy.
Then Jacinta’s situation will hurt the family, robbing us all of the chance to be happy. We all will be miserable.
Jacinta will never recover. She’ll always feel tormented.
“Okay, Fatima. Great job! I know that was very difficult. You see we have these thoughts spinning around in our head. This keeps us anxious. It is best to write down our worries on paper. This stops the spinning and the never ending cycle. It allows you the chance to deal with each one.”
“I see what you mean.”
“Good. Now let’s look at the first thought and see if it is really 100% True.”
“We will use the cognitive distortions to check how true the first thought is. You know those mistakes in thinking we all make when we are upset. So, my understanding of Jacinta is that up until she went to get support at the hospital’s psychiatric department, she was a good student. Right?”
“Yes, she never found learning a problem.”
“How was she with her friends? “She had a large group of girls that she hung around with and with whom she got along well.”
“Were the girls in the group, dependable? I mean ‘good students’?”
“Yes, there were. Also, Jacinta was involved in sports, and she is also a dancer and studies ballet quite seriously. Plus she loves art. I paint and so, I guess Mother-like-daughter.”
“Well, you are telling me that Jacinta was an all-around-talented young lady?”
“Yes, before the episode of going to the hospital.”
“Okay, so, Fatima, when you are telling yourself that Jacinta is fragile, knowing that there is no doubt that she has been having a difficult time, while at the same time, you are telling me that she is strong at school, social contacts, outside interests and sports.”
“Would this be a cognitive distortion called Mental Filter where you leave out all the positives and where you just think about her time at the psychiatric unit?”
“Well, that’s a distortion. It seems that Jacinta has lot’s of strong areas. And what about Discounting the Positive. Are you leaving out all the positive things when you tell yourself that your daughter is fragile?”
“Yeah, I guess I am.”
“Well, that makes two distortions. How about Jumping to Conclusions: Fortune Telling where you predict that things will turn out badly? Can you tell the future?”
“That makes three distortions. Let’s look at Emotional Reasoning. Are you using your feelings to think with? – It feels as if she is fragile so she must be fragile?”
“So, Fatima, we have four distortions. What about Magnification? Are you making this bigger than it is? If your daughter has been a strong person in all areas of her life for over 16 years, how would she suddenly change? Don’t you think she is a strong person underneath? Isn't she just another teenager who is going through a hard time?” “Yes, I believe so.”
“Then you are making it bigger than it really is. That makes five distortions. We could ask you if there are any ‘shoulds’ in your thought that Jacinta is fragile. Are you thinking that this shouldn’t be happening to her?”
“Well, that is a distortion. There are only three valid shoulds and your should isn’t one of them. There is no reason that a strong person can’t have a hard time. None of us is totally protected from the bumps in life. What do you think?”
“You are right. I couldn’t believe my talented daughter was having a hard time mentally and couldn’t accept it.” “Well, isn’t it true that life is full of surprises, that anyone can have a sudden bump like a cancer diagnosis or have a car accident despite being a wonderful person?”
“I guess you are right.”
“Well, Fatima, with your 'shoulding', we are up to six cognitive distortions or twists in your thinking “Jacinta is fragile.
What would be more true, more realistic and positive?”
“That at her core, Jacinta is strong.”
“Would that be 100% true?”
“Then if that thought is 100% true, how true is the thought that Jacinta is fragile.”
“Well, not true at all.”
“If that is not true, how true is that she will make bad decisions?”
“Not true, at all.”
“And that she will take the wrong path all the way to “There would be no recovery. She will always feel tormented?”
“Not true at all.”
“How worried are you now about Jacinta’s future.” “I’m not!”
“Congratulations! You talked back to your negative thoughts which were really lies you were telling yourself. You defeated them. So what are you going to tell yourself before you fall asleep?”
“That I love my daughter. I can pray for her and I can tell myself, “My daughter, Jacinta is strong at her core. She is talented. She is smart. She can get through this and have a bright future!”
“What a Mom! You are really gung-ho with talking back to the lies you were telling yourself!”
“Listen. You did the changing. Thank you for being so courageous!”