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|Practice Makes Perfect - Page 6|
At the next session, a smiling Don reported consistent practice following my phone call. He also said he couldn't generate a relaxed state easily, so we moved on to learning some new "circuit breakers," as well as rehearsing some external time-out sessions.
In my work with highly reactive clients, once they can easily access a calm baseline, I elicit the problematic excited state and diffuse it there in my office, teaching them a variety of tools they can use to do the same for themselves outside of therapy. So I asked Don, while in a state of relaxation, to recall a recent conflict between him and Cara, particularly the moment when he felt overcome by his rage. I then directed him to revive this feeling, becoming aware of where in his body he held the tension. Once he'd identified the somatic cues of imminent overreaction, he was to visualize excusing himself, telling Cara that he was taking a time-out and would be back in just a couple of minutes. I suggested that he then imagine going where he wouldn't be disturbed—the bathroom or outside the house—and doing some of his relaxation exercises.
In his ensuing sessions with me, Don learned how to do regular mini sessions and internal time-outs—the latter proving to be particularly helpful when he and Cara were in the car together and he had no ready escape. As time passed, Don reported that he sometimes began replacing external with internal time-outs, finding it less necessary to separate himself from Cara to implement his new, calming techniques. With the aid of a few more between-session phone calls, he adhered to his practice and began to incorporate his new tools successfully. He saw me 12 times over six months—weekly for the first two months and then monthly for reinforcement sessions. Unlike Bill, Don concluded his sessions with me feeling he was able to make use of what he'd learned in therapy even when triggered by the unexpected but inevitable conflicts in his relationship. His marriage is intact today.
How long does it take to change ingrained habits and patterns, or for fears to diminish? Some things can change quickly—specific phobias can diminish within three to five sessions, for example. Generally, however, it takes many practice sessions for habituated reactive responses to change, and for brain patterns to rewire. The key word in how to accomplish this is practice.
I've found that when I stick to the firm expectations and structure of the homework contract, visualization, and implementation, practice becomes a regular feature of my clients' therapy. This, in turn, increases the likelihood that they'll be able to transfer the skills learned in session to their daily activities and succeed at changing their lives. In the end, practice may not make perfect, but it certainly helps.
Carolyn Daitch, Ph.D., is director of the Center for the Treatment of Anxiety Disorders in Farmington Hills, Michigan. She's a certified and approved consultant with the American Society of Clinical Hypnosis, a consultant with the University of Michigan's Program of Integrative Medicine, and a certified Imago Relationship therapist. Contact: firstname.lastname@example.org.
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