Externalization of Voices: Role Play Setup

Today, we are pleased to present the exciting conclusion of our work with Madeleine, a loving mother who fears that her eldest daughter might be in mortal danger during her year abroad. Last week, you heard about the T = Testing and E = Empathy phase of the live work with Madeleine, a mother feeling intense panic and helplessness and inadequacy because she fears that her daughter could be in grave danger of abduction and worse. This week, we will focus on A = Paradoxical Agenda Setting, using the Miracle Cure Question, Magic Button, Positive Reframing, and Magic Dial to see if we can melt away her resistance to change.

You can see the Emotions table of the Daily Mood Log Madeleine during the Magic Dial portion of the session if you

As you can see, she wanted to reduce her negative feelings somewhat, but thought she still wanted to keep them fairly elevated, since she still sensed that her daughter might be in real danger, and clearly did not want to abandon her.

This is one of the significant refinements in TEAM CBT. First, we want to bring the patient's resistance to full conscious awareness. Second, we want patients to full grasp that their negative thoughts and feelings do NOT result from some "defect" or "mental disorder," but rather from what is most beautiful and awesome about them as human beings.

After the Magic Button, David and Jill went on to the final, M = Methods portion of the TEAM session, using tools such as Identify and Explain the Distortions, the Double Standard Technique, and the Externalization of Voices, with the Acceptance Paradox, the Self-Defense Paradigm, and the CAT (Counter-Attack Technique). We will, of course, do numerous role reversals to see if we can get Madeleine to a "huge" victory over her many distorted thoughts.

You can see the Daily Mood Log Madeleine prepared at the end of the session if you

As you can see, the reductions in negative feelings were dramatic, but in several areas (anxiety, inadequacy, frustration and anger), Madeleine's negative feelings were still minimally elevated. That is one of the reasons we decided to schedule an additional session together several weeks later to see if we could intensify Madeleine's responses to her negative thoughts, and hopefully due some Cognitive Flooding to complete her "treatment."

At the end of these show notes, you will find an email from Madeleine after the session that includes her end-of-session scores on the BMS and EOTS. You will also see comments submitted by many participants who attended the webinar live.

This email below from Madeleine following the session shows her end of session scores on the Brief Mood Survey as well as the Evaluation of Therapy Session at the end of her session with Jill and David.

Hi David,

Yes, here are my BMS & ETS score totals after the extended session. Please let me know if you have any questions. A relapse prevention session would be nice; however, I hesitate to accept your offer as you all are so busy. Please know that I am practicing the PTs and keeping the NTs in check for now.

Thank you again a million times over😊. Yes, Feel free to use the recording however you like. Like I said, it's the least I can do to contribute to your generous and vitally important work. You are both very inspiring in so many ways. Much gratitude, Madeleine

Brief Mood Survey (BMS)

Depressed 0 / 20 (complete elimination of depression)

Suicidal 0 / 12

Anxious 2 / 20 (near-complete elimination of anxiety)

Angry 0 / 20

PF 36 / 40 (dramatic improvement in Positive Feelings)

RS 29 / 30 (large improvement in Relationship Satisfaction)

Evaluation of Therapy Session (ETS)

Empathy 20 / 20 (perfect)

Helpfulness 20 / 20 (perfect)

Satisfaction 8 / 8 (perfect)

Commitment 8 / 8 (perfect)

Neg feelings 1 (0 – 4) (uncomfortable at times!)

Difficulties w/ answering the questions honestly 0 (0 – 4) (no difficulties)

What did you like the least? Crying and blathering in front of all those people. Fortunately, I wasn't able to see any faces except yours😉

What did you like the most? Jill's "smooth as silk" empathy skills, David's laser sharp questions, Jill's rephrasing & untangling of the PT to "unlikely," David's having me write powerful PR stuff down, Jill & David's EOV - so strong, David counterattacking my neg thoughts with "sociopath," Jill's double std delivered in a very gentle way. I never felt rushed!

Feedback for Madeleine from the chat during the session

Comments for Madeline:

• Madeline!!! I want you as a therapist. Your ability to show how to feel and describe the feel is courageous and admirable. Thank you.
• Thank you for sharing Madeline, I can completely relate with you as a mother when we worry and has no control on their actions
• Definitely relate to Madeleine and appreciate her vulnerability.
• Thank you for your transparency, Madeleine. We appreciate it and can empathize
• I totally relate. My children are 30 and 32, I parented in the 90"s; i was trying to break the abuse cycle, so i missed nurturing their emotions and building their self esteem. My children give me so much grace and say how much they love watching me as a grandparent. I am so proud of the grandmother I am!!!! I am so grateful to be a part of their journey and blessed to have a second chance at creating that safe space for all of them.
• wow. this event really open up the deeper pain in your life. Feel honored that you are opening up to us.
• I'm so much appreciating Madeleine's being vulnerable and her sweetness and maternal care/nurturance and how David and Jill are working with her. Helpful learning experience. Thank you all.
• Thank you Madeline! It was brave and kind of you to share your story for today's demo!!
• Shows she is courageous n strong woman
• I am in awe over how Madeleine's resistance to looking at inadequacy actually brought out the most amazing positives and core values. Beautiful!
• I also just got the chills
• She is great mother
• She is caring person cares for others
• Madeleine is so incredibly courageous sharing her story here being so vulnerable too I appreciate how real this is and thank you all for the work you do for helping Madeleine through this and for providing
• this very inspirational training :)
• As a mother and also deep empath, much of what she is sharing definitely resonates.
• I hope she's able to continue working with her struggles and strengths to heal and feel better sooner than later 💗
• Madeleine, it means so much to hear you. I was in trouble with an abusive boyfriend when I was college aged. I would have given anything to have my mother give me support at that time. I felt completely alone navigating the relationship and unable to get out. I needed an "adult in the room". Just hearing and seeing you right now is huge for me. Your daughters are lucky to have you! It's clear that you have their back and I'm sure they know it. I feel like you bring your whole heart to being a mother, truly beautiful and awesome! Thank you so much for volunteering today.
• Hi Madelyn, I'm also a mother like you. I am a sensitive person like you and worry about how evil the world is. I worry for my daughter's future. My daughter has a beautiful sensitive, innocent soul. The fact that we feel this way shows that we are kind emphatic people. The only way not to suffer about these issues is to be a sociopath, to be part of the satanic community that is responsible for the ugliness in the world. I don't want to be part of this evil community. It is our political systems responsibility to spread the stoic values that make just, reason/logic driven people, brave, kind and educated driven people. As for myself, I'm proud of who I am and find peace and comfort in studying stoicism. I believe that if we all learned about stoicism our world would be a much better place.
• And there's just as many Creeps and Sociopaths in your hometown as abroad. What's increasing her safety is knowing she has an open line of communication to her mom. That kind of girl is not such a target. Creeps are looking for girls without strong roots, without "backup". Girls with a a major insecurity to fill. Your type of parenting is exactly what's made her safer. Just to add to externalization of voices if we're allowed or supposed to!
• In case Madeline sees this chat, I feel compelled to share that I studied abroad in the spring semester 1998, in Jerusalem at Hebrew University. I turned 21 that semester (as did my group of new friends). Hands down it was the most formative and important experience of my life to build trust in myself, feeling able to navigate the unexpected, land somewhere totally new and make new friends and figure things out. My worried mother heard all kinds of yucky things in the news that was happening there (things that I never saw). We navigated our safety, traveled on weekends and breaks. And since, I have regularly offered the recommendation, both solicited and unsolicited, about the incredible merits of studying abroad, Of course, our mama-bear hearts will be called to protect our babies. And, sounds like your girl is gritty and brave, open to new experiences, adventurous, and eager to experience life!
• Madeline's empathy and compassion and counterattack stating "I taught her to see the Beauty in the world "is profound and amazing and reverberates for coaching and self empathy! Wonderful Madeline, David and Jill!
• Thank you Madeleine for being so vulnerable, honest, and open to aid our learning. SO touching and relatable.
• M's standard for herself and parents is so very high and unattainable! She is doing way more than most by just caring this much.