Practice Makes Perfect - Page 3


Visualization

During every office session, I help clients visualize themselves engaging in their newly learned behaviors and practicing these techniques at home. For example, I might have a client rehearse the use of positive self-statements and deep-breathing to increase calmness, all the while imagining a spouse berating or criticizing her. Then we'd rehearse ideal reactions. An added benefit is that this exercise helps clients anticipate the kinds of situations that'll require them to use these new tools.

Following the behavioral rehearsal, we rehearse the practice sessions that the client will do at home. I do this because I've found that clients need to practice practicing! In therapy, I direct clients to visualize an extended daily practice, mini practice sessions, and a number of typical scenarios in which they'd likely be triggered and then successfully use the new, calming tools to maintain equanimity. Visualizing the practice sessions helps clients realize that it's feasible to integrate them into their daily lives and enhances commitment. Clients begin to understand that using this kind of affect regulation can be part of a lifelong discipline.

I typically use hypnosis for helping clients rehearse new ways of behaving and committing to homework. But people who aren't trained in hypnosis can teach clients to relax with a few deep breaths, and then have them visualize (with eyes closed, if comfortable) doing the new behavior.

Implementation

I provide clients with four discrete types of practice session that are briefly rehearsed at the close of each therapy hour:

Extended Time-out - One Daily, 20-Minute Session

A daily practice of meditation or self-soothing mitigates the negative effects of stress. Accordingly, I ask each client to choose a time and a place in which he or she will relax each day for 15 minutes, followed by 5 minutes practicing a newly learned therapeutic skill. I teach my clients self-hypnosis to enter this calm state of being, but progressive muscle relaxation, guided imagery, systematic desensitization, mindfulness, and other forms of relaxation will work as well. Once clients have established a specific time and place for this meditative exercise, I encourage them to set reminders, such as programming a daily reminder on a PDA or cell phone. Day planners or Post-it notes work just as well for the less technologically adept. I seek the verbal commitment of each of my clients to engage in the practice sessions, follow up on the client's interim practice at each session, and sometimes phone between sessions, just to check in and see how the practice is going. My clients and I have sometimes joked that I'm really their thera-pest. But often a five-minute phone call or a brief voicemail message is all an errant client needs to get on the ball and start practicing.

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