Saturday, 18 February 2017

Helping Patients to Explore Their Values in Therapy

One thing that I have found to be very helpful in working with patients is to examine their values as well as ways in which their current behaviors may not be in-line with their values.

I specialize in working with teens and adults with eating disorders and body-image issues. I often talk with my patients about how eating disorder behaviors-as well as other self-harming behaviors-are often ways that they are attempting to get their needs met (i.e. to feel a sense of “control” or manage anxiety). These behaviors may temporarily provide relief. However, in the long run, they only serve to bury the underlying issues and cause people to feel even worse.

I utilize a variety of tools and strategies in helping people to break free from eating disorders and body-hatred. However, regardless of the issue that brings someone to therapy, I believe that helping clients to develop a greater sense of their values is important.

The following is a brief exercise that I often will have clients do, which is adopted from “The Happiness Trap” by Dr. Russ Harris.

  • Imagine that you are in your 80s looking back on your life and complete the following statements:
  • I wish I would have spent less time….
  • I wish I would have spent more time…
  • If I could go back to (client’s current age) and do something differently, I would…

This exercise can be very helpful in defining the client’s ultimate values. Thinking about what your perspective could be like in your 80s can often help to put things into a broader context.

 The following is another exercise that I sometimes will ask patients to do, to help them to examine their values.

  • Imagine that you have a bunch of jars in front of you. Each jar is a different category of your life, i.e. romantic relationship, career, health, appearance, hobbies, friendships, family, etc.
  • Now imagine that you have a jar with a limited amount of marbles. Into each jar you put some of the marbles that you have based on the amount of mental energy and effort that you put into each category.
  • Which jars are the fullest?
  • Which jars are the least full?
  • Knowing that you only have a limited amount of marbles, are there any shifts that you would like to make?

Lastly, while it may seem morbid (and you must carefully consider that it is appropriate prior to using it with a specific client), I will sometimes talk with clients about how they ultimately would like to be remembered. I have had conversations with clients about how no one writes in an obituary, “she was the perfect weight” or “she ate so healthy.”

Ultimately, it is our passions, our relationships and the way that we give back to others that is how most of us will be remembered.

I also will talk with clients who are struggling with body image issues about how even if they loved their bodies and appearance, the reality of life is that we are all going to change as we age. Thus, tying your self-worth to your appearance is a recipe for discontent.

Thinking that we only have a finite amount of time is one way to start to recognize that the ways in which we spend our time matters. If mental illness is getting in the way of someone living according to their true values, it is so important that they seek appropriate help and support.

 

 



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