How can core beliefs be modified? - Chapter 18

This chapter discusses how to modify beliefs.

When clients are in a maladaptive mode, it is important to:

• Develop and strengthen realistcally positive beliefs to activate the adaptive mode.
• Modify the unrealistic, negative beliefs to deactivate the depressive mode.

During treatment, it is important to reinforce the more positive beliefs by helping clients to engage in activities that could bring a sense of mastery, pleasure, connection and empowerment. Other important strategies are:

• Eliciting positive information and inferring helpful conclusions about their experiences.
• Eliciting the advantages of believing adaptive beliefs.
• Pointing out the meaning of positive data.
• Referencing other people.
• Using a chart to collect evidence.
• Inducing imagies of current and historical experiences.
• Acting 'as if'.

What are some techniques to modify maladaptive core beliefs?

Techniques to modify core beliefs are: Socratic questioning, examining advantages and disadvantages, intellectual-emotional role plays, acting ‘as if’, behavioral experiments, cognitive continuum, self disclosure, core belief worksheet, extreme contrasts, stories and metaphors, historical tests, restructuring early memories and coping cards. The first 7 were already discussed in previous chapters, the remaining are additional techniques and will be explained.

In the core belief worksheet clients monitor the operation of their beliefs and reframe evidence that seemed to support the old belief. Clients have to recognize positive data. Clients might find this difficult and the therapist might use some techniques to make it easier, such as making clients think about what they would say to another person or what another person would say about them.

Using extreme contrasts to modify core beliefs is another technique to modify core beliefs. It can be helpful for clients to compare themselves with someone, either real or imagined, who is at the negative extreme of the quality related to their core belief. Using stories, movies and metaphors can help clients develop a different idea about themselves by encouraging them to reflect on their view of characters or people who share the same negative core belief.

‘Historical tests of the core belief’ is another technique. With this technique clients try to discover where their belief started. Clients record memories that may have contributed to the establishment or maintenance of the core belief; this can be continued in homework assignments. A second step in this process is to search for evidence in memory that supports the new, positive belief. The third step is to reframe each piece of negative evidence.

In the fourth and last step clients summarize their memories. For many Axis I clients the intellectual techniques discussed above are sufficient to modify their core belief. For others, special emotional techniques, in which clients’ affect is aroused, are also indicated. One such technique is restructuring an earlier traumatic experience. The therapist and client can engage in role-play to reenact and reinterpret an earlier experience. They stop when the client reports that the younger-self is feeling less sad or anxious.