Practice Makes Perfect



"I'm sorry for canceling on such short notice, Dr. Daitch. Therapy was really helpful," Bill began half apologetically. "You taught me how to keep my cool when Denise criticizes me, instead of exploding at her, but it just isn't working. I know about active listening and validation. The problem is that when I'm home, I just can't do it: I can't stop myself from overreacting. She starts nagging, and before I know it, I'm screaming at her. It's not your fault. Therapy's just not the answer for my problem."

How could I argue with him? He was describing a common dilemma for clients: in the contained, nurturing therapeutic setting, it's relatively easy for them to learn rational reactions and rehearse intentional responses. But life comes at you fast, and it's extremely difficult for clients to transfer these skills to actual situations, when they're suddenly overwhelmed by their emotions. The stress, anger, and anxiety evoked by everyday confrontations and interactions can easily overwhelm our clients' best intentions, completely dislodging newly learned techniques for keeping their cool—no matter how much they practice these techniques in sessions. At that point in my practice, I had no idea of how to help emotionally overreactive clients take what they'd learned in therapy into their lives outside my office.

That was 10 years ago. Bill didn't resume therapy with anyone, and a year later, I heard that his wife had divorced him. The only good outcome of…

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