knr 253 cognitive therapy anger management humor
TRANSCRIPT
KNR 253
Cognitive TherapyAnger ManagementHumor
Overview
Cognitive Therapy Austin, 2009 McKay, Davis, & Fanning, 1981
Anger Management Dattilo & McKenney, 2011 Internet
Humor Dattilo & McKenney, 2011 Austin, 2009 Internet
Cognitive Therapy
Psychotherapy Started in 1960’s Aaron Beck Albert Ellis
Used with Depression Anxiety
Post Traumatic Stress Disorder Obsessive Compulsive Disorder
Anger Stress Others
Cognitive Therapy Based on…
1. All of your moods are created by your thoughts. You feel the way you do right now because of the thoughts you are thinking at this moment
2. Emotions have little to do with actual events. In between the event and the emotion is realistic or unrealistic self-talk
3. Emotions come from what you say to yourself…your interpretation of the event
4. If you are feeling depressed, your thoughts are dominated by pervasive negativity
5. Negative thoughts that cause emotional turmoil nearly always lead to gross distortions or distortive cognitions
Cognitive Therapy
Seeks to identify and change distorted unrealistic ways of thinking and influence behaviors and emotions
These thoughts occur rapidly while in middle of a situation or when recall events from past
These are thoughts we always say to ourselves in certain situations
Cognitive Therapy
These thoughts are …AutomaticRepetitivePessimisticUnrealistic expectationsOverly critical self evaluationsSelf-talk
Distorted Thinking
Filtering Take negative details & magnify them while filtering
out all positive aspects of the situation Only see the negative comments in your performance
appraisal and not see all the positive ratings
Polarized thinking Things are black or white, good or bad. You have to
be perfect or you’re a failure. There is no middle ground
If you are not perfect you must be a failure
Distorted Thinking
Overgeneralization You come to a general conclusion based on a single incident or
piece of evidence. If something bad happens once you expect it to happen over and over again
I’ll never learn to dance I’ll never be able to trust anyone again
Mind reading Without their saying so, you know what other people are feeling
and why they act the way they do. In particular, you are able to know how people are feeling toward you
Jump to conclusions that are true for you and assume others share your belief
He’s just acting that way because he is jealous
Distorted Thinking
Catastrophizing You expect disaster. You notice or hear about a problem and
start “what ifs.” What if a tragedy strikes? A small leak in your boat means it will sink A headache means that you have brain cancer
Personalization Thinking that everything people do or say is some kind of
reaction to you. You also compare yourself to others, trying to determine who’s smarter, better looking, etc.
A man whose wife complains about rising prices hears the complaint on an attack on his ability as a breadwinner
Distorted Thinking
Control fallacies If you feel externally controlled, you see
yourself as helpless, a victim of fate If you feel internal control you are responsible
for the pain and happiness of everyone around you
Distorted Thinking
Fallacy of fairness You feel resentful because you think you know what’s
fair but others won’t agree with you If you love me then you will help do the dishes If you love me you would go dancing with me
Blaming You hold other people responsible for your pain, or
take the other tack and blame yourself for every problem
The teacher is responsible for my poor grade because she didn’t give good directions for the project
Distorted Thinking
Shoulds You have a list of ironclad rules about how you and
other people should act. People who break the rules anger you and you feel guilty if you violate the rules
I should never make mistakes I should never be tired or get sick
Emotional reasoning You believe that what you feel must be true. If you feel stupid and boring, then you must be stupid and boring
Distorted Thinking
Fallacy of changeYou expect that others will change to suit you
if your just pressure or cajole them enough Global labeling
You generalize 1 or 2 qualities into a negative global judgment
A person who refused to help you with your project is a total jerk
Distorted Thinking
Being right You are continually on trial to prove that your opinions
and actions are right. Being wrong is unthinkable and you will go to any length to demonstrate your rightness
Heaven’s reward fallacy You expect all your sacrifice and self-denial to pay off,
as if there were someone keeping score. You feel bitter when the reward doesn’t come
McKay, Davis, & Fanning, 1981
What Is Your Most Used Distortion? Filtering Polarized thinking Overgeneralization Mind reading Catastrophizing Personalization Control Fallacies
Fallacy of fairness Blaming Shoulds Emotional reasoning Fallacy of change Global labeling Being right Heaven’s reward fallacy
Cognitive Therapy Interventions
Goal is to help recognize and change distorted thinking Focus on present Problem solve Learn basic principles Learn specific skills
Thought stopping Listen to thoughts. When cognitive distortion occurs,
say “stop” to self or other person Restructure to a more realistic positive statement
Cognitive Therapy Interventions
Affirmations Positive, reasonable statements are made about
yourself They are stated in first person and in present tense
I am …
They are stated with conviction and should be repeated throughout the day
Helpful to place affirmations in places where they are visible and easy to read
Cognitive Therapy Interventions
VisualizationPractice desired behaviors in mind before
doing them Visualize yourself doing each component Ignore negative thought Relive successes instead of failures
Role play
Cognitive Therapy Interventions
Cognitive restructuring Systematic plan where distortions are
restructured into positive statements which are incompatible with distorted thought
1. Name your emotion
2. Describe the situation or event
3. Identify your distortions
4. Rewrite your distortions
Anger Management
Dattilo & McKenney, 2011
Anger Management
Is a cognitive-behavioral intervention Both learning and thinking are important in the
acquisition and maintenance of behavior Cognitive: based on distorted thinking; intervention seeks to
change thoughts Behavioral: problems based on environmental reasons that
result in poor social skills and not distorted thinking Cognitive-behavioral: intervention focuses on distorted
thinking and social deficits
Definitions
Anger Emotional excitement induced by intense displeasure
Grinding teeth, raised voices (behavior) Tense muscles, perspiration (physiological)
Aggression Anger often is a precursor to aggression Exhibition of actions toward people or objects with some intent to
hurt or injure Physical Verbal Gestures Bullying
Definitions
ViolenceViolence may come from aggressionFrequently seen in media
Murder Assault Rape
Anger Management
UsesBehavioral problemsMental health problemsLegal problems (incarcerated, probation)Others
Anger Management Interventions
Anger Control Program Anger Coping Program ZIPPER Strategy
Don’t Laugh at Me
ZIPPER
Z: Zip your mouth Hand motion stop, deep breath, finger across mouth like zipper
I: Identify the problem Deep breath, put finger to temple, identify problem
P: Put off what you want to do Pause, deep breath, “I may find a better way to handle this,” “Don’t get
angry.” P: Put yourself in control
“Stay cool,” put hands on hip, turn thumbs up, “I’m in control.” E: Explore other solutions
“What can I do?” Shrug shoulders, explore other options R: Return to what you were doing
“I’ve made it. Return to activity
Humor
Dattilo & McKenney, 2011
Have you ever benefited from using humor in your own life?
What are some ways humor might be beneficial in a TR setting?
Theoretical Foundations
Incongruity theoryDifference between what is expected and
what actually happensHas an element of unexpectedness
Psychological releaseRelease tension
Outcomes
Reduce anxiety & depression
Increase pain tolerance
Improve immune system functioning
Improve self-concept
Improve interpersonal relationships
Improve memory Assist with recovery
from surgery Assist ability to learn
Possible Uses in TR
Functional intervention/treatment Use with people receiving treatment for cancer,
dialysis, burns, etc. Use to help with memorization skills Others
Leisure education Humor development Humor appreciation Stress and humor
Possible Uses in TR
Recreation participationHumor roomsHumor cartsMoviesSkits produced by clients
Sample Programs
The Humor Project A Tonic You Can Afford The Healing Power of Humor How to Develop Your Sense of Humor The Comedy Club Humor Production Procedure Also provides a couple exercises
Activity: Add Some Nonsense
Making fun of problems can help people get new perspective and remove power of the problem Write 5 things that regularly cause you stress Number in order of least stressful to most stressful Write a short laugh sound after each sentence
“Ha ha” “Tee hee” Nobody ever listens to me….ha ha
Cognitive Therapy / Anger Management / Humor / Reminiscence Lab
Group session that enables group members to practice principles and techniques of cognitive therapy, anger management, humor, or reminiscence.