Thank you for choosing me to help you through what may be one of the most difficult and interesting challenges of your life. We each have part of the solution, and if we work well together we are likely to achieve good outcome. I have a lot of academic knowledge and practical experience about the cause-and-effect principles that influence souls such as yours, and you have a lot of knowledge about what you really want and the challenges you have to overcome to achieve it. [If you do not know what you really want, that can be a good focus of our collaboration].
Our collaboration is successful to the extent that it produces the outcome you want. Part of my job, as the experienced member of our team, is to help us avoid the standard pitfalls of this kind of relationship. Many clients are verbally skillful. Impressing me with great insights and excellent problem solving skills is easy for them. Insights and epiphanies are fun and can be useful, but the irreversible changes that produces good long-term outcome result from the more effortful work of training the creature you inhabit to cope with the things that happen, even when I am not be around to admire, help or remind you.
Anything as valuable as the capability to follow your path of greatest advantage comes at a price. It takes effort to enhance the mental faculties and practical skills to respond mindfully despite the things that happen. Many strategies and exercises are available here to enhance your progress. Some involve manipulating your subjective experience; others are more mundane and may involve filling out forms, or writing me an email describing how a personal experiment went. Be careful! Each of these activities can be postponed or forgotten, which sets the conditions for a subtle but devastating trap that can destroy our relationship.
The term, “Iatrogenic” refers to a pathological condition caused by treatment efforts. Psychotherapy is iatrogenic when it does more harm than good. If you agree to do something and then fail to do it, you will have set the bad precedent that you make a commitment and then fail to adhere to it. This is an iatrogenic trap that is so easy to fall into that it requires vigilance to avoid.
Here is the set up: During our sessions I may suggest a personal experiment that will seem sensible and easy to do, and so you may nonchalantly agree to do it. But once you leave the quiet, rational world of my office and return to the chaotic world of everyday experience, you may lose track of it and not get it done by our next session, which leaves our collaboration in an awkward position
Suggestions Regarding Assignments
- Be assertive. Please feel free to reject assignments any and all assignments. This mode of collaboration may not be a good one for us to use.
- Be open about the practical difficulties and realities that make completing the assignment problematic.
- If forgetting is an issue, please arrange for a reminder call from our receptionist.
- Remember, assignments and personal experiments are goals not commitments— unless you formally commit to do one (in which case you have to do it). Changing your mind about doing a personal experiment is always acceptable. In fact, making changes on the basis of new and unexpected data is part of the investigatory model that drives the personal experiments.
- Understand this: “Success and failure,” “strong and weak, “good and bad” are judgmental fictions we create and are usually not helpful for the purposes of our collaboration. Instead, I recommend that we research how your subjective reality works so we can make changes that bring about the outcomes you want. In this sense, whatever happens, including the sequence of events that interfered with doing the assignment, provides us with valuable and valid information.
Here are some tools. We are not limited to the formats presented below, and I am open to any ideas you have about forms and methods. As a rule of thumb, it is worth the effort to use concrete devices such as forms to structure our efforts. However, you are the director of our collaboration and know much more about the important variables than I do. So please feel free to pick and choose among the suggestions I offer.
- Prior to each session, I would like you to complete either the Relapse Prevention Feedback Form if our target is an Incentive Use Disorder, or the Psychotherapy Feedback Form if we are working on a problem of Depression, Anxiety or Anger. Feel free to leave fields blank and to include as much or as little detail as you like. Bring it with you to our session, or send it to me electronically.
- If depression, anger, or anxiety is an issue for you, Please download The Mood Treatment Manual. In addition, I would like you to complete the Depression/Anxiety Symptom Inventory periodically, e.g., weekly or monthly. We will specify the frequency when we develop our plan.
- During our sessions we will probably develop excellent plans that would change your life for the better, if you actually implemented them. Most people take it for granted that they will do what they agreed to do, especially since it sounded so sensible during the session. Indeed, executing the plan at the critical moment is more challenging than you think. If this turns our to be an issue for you (and it probably will), the Intentions & Action Form will help. Remember, only if you execute the plan can we discover if it does any practical good.
Tools for Incentive Use Disorders – The tools listed below are designed to help us work together on solving you addictive trap
|Trap Detector||Identify your addictive traps|
|Treatment Plan||Treatment planning tool|
|History Review||Learn from previous relapses|
|Intentions and Actions||Personal experiment data sheet|