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Authors: Beverly Engel

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others to treat us with respect and kindness, we must first start giving these things to ourselves.

If you would like more information on Mirror Therapy contact me at:

P.O. Box 6412, Los Osos, CA 93412-6412, [email protected].

Voice Therapy

The clinical psychologist Robert Firestone’s pioneer work in identify- ing the origins and destructiveness of the inner critic led to his process “voice therapy.” In voice therapy, clients are taught to externalize their inner critical thoughts. By doing so they expose their self-attacks and ultimately develop ways to change their negative attitude about them- selves into a more objective, nonjudgmental view. As the voice of the inner critic is externalized through verbalization, intense feelings are released that can result in powerful emotional catharsis, accompanied by important insights. (Firestone’s methods are primarily used in the context of individual and group therapy. I include here some adapta- tions of his methods that you can try on your own.)

Voice therapy is a method of eliciting and assessing pervasive neg- ative thought processes that represent an alien part of the personality (an inner saboteur). The method combines cognitive, affective, and behavioral components into an integrated treatment strategy. Voice therapy includes the following steps:

Identify the negative thought patterns that regulate maladap- tive, self-destructive behavior, and encourage the release of the negative affect associated with this thinking process.
Trace these destructive thoughts to their origin; that is, patients identify the source of these thoughts and attitudes in their early experiences. They discuss their personal insights and identify the self-defeating or self-destructive patterns that the negative thoughts predispose.
The final step makes up the majority of therapeutic work. Attempt to implement behavioral change in a direction that

counters these destructive thought processes and leads to a more constructive ways of fulfilling one’s goals and potentialities.

The techniques of voice therapy bring internalized, negative thought processes to the surface with accompanying affect in a dia- logue format so the patient can confront elements of the personality that are antagonistic toward the self. It is referred to as voice therapy because it is a process of giving language or spoken words to critical thought patterns that are at the core of an individual’s defensive behavior and lifestyle. This method can be used in a variety of clinical populations and is particularly valuable in understanding and working with patients with depression and diverse forms of substance abuse.

Firestone is the author of six books and over twenty published arti- cles, and the producer at the Glendon Association of thirty-five video documentaries used for training mental health professionals. To learn more about voice therapy, you can read his book
Voice Therapy: A Psychological Approach to Self-Destructive Behavior
, or you can con- tact him at the Glendon Association through their Web site, www

.glendon.org.

The Solutions Program

The Solutions Program can help if you would like more assistance learning how to self-nurture and set more effective limits (especially important for those with an eating disorder). If we have not mastered two skills—
self-nurturing
and
effective limit setting
—we cannot soothe and comfort ourselves from within. Consequently, it is only natural that that we will tend to soothe and comfort ourselves by overeating, drinking, spending, overworking, and smoking, or by peo- ple-pleasing, rescuing others, putting up walls, or thinking too much. The Solutions Program was developed over the last twenty years at one of the nation’s most prestigious medical schools, the University of California, San Francisco, School of Medicine. Emerging understand- ings of neurobiology suggest that using the skills over the long term may retrain the elusive
feeling brain
to spontaneously favor a life of emotional balance, relationship intimacy, spiritual connection, and

freedom from excessive appetites.

By using the self-nurturing and effective limit-setting skills, over time they become automatic. When they do, we spontaneously soothe and comfort ourselves
internally
so we no longer need the common
external
solutions to distress.

I recommend that you read the book
The Pathway: Follow the Road to Health and Happiness
by Laurel Mellin, M.A., R.D., to learn about what she calls “cycles” (the nurturing cycle and the limits cycle). If you want more support, there are hundreds of Solutions groups nationwide led by health professionals, as well as self-help Solutions Circles and an active Internet community.

For more information, read
The Pathway: Follow the Road to Health and Happiness
or contact the Institute for Health Solutions at

(415) 457-3331, www.thepathway.org

Treatment of Post-traumatic Stress Disorder

Emotional abuse can cause a person to suffer from post-traumatic stress disorder. In addition, many who were emotionally abused as children were physically or sexually abused as well. There are several treatment options.

Cognitive Behavioral Therapy (CBT)

Increasingly used in the treatment of dissociative disorders (DID) and borderline personality disorder (BPD), dysfunctional and mal- adaptive behaviors, thoughts, and beliefs are replaced by more adap- tive ones.
Exposure therapy
is one form of CBT unique to trauma treatment that uses careful, repeated, detailed imagining of the trauma (exposure) in a safe, controlled context, to help the survivor face and gain control of the fear and distress that was overwhelming in the trauma. Along with exposure, CBT for trauma includes learning skills for coping with anxiety (such as breathing retraining or biofeed- back) and negative thoughts (cognitive restructuring), managing anger, preparing for stress reactions (stress inoculation), and handling future trauma symptoms, as well as addressing urges to use alcohol or drugs when they occur (relapse prevention), and communicating and relating effectively with people (social skills and marital therapy).

Eye Movement Desensitization and Reprocessing (EMDR)

This is an interactional method that accelerates the treatment of a wide range of pathologies and self-esteem issues related to past events and present conditions. Numerous studies show that it is effective in the rapid desensitization of traumatic events, including a cognitive restructuring and a reduction of client symptoms.

The procedure produces rapid eye movements in a client while a traumatic memory is recalled and processed. This technique seems to lessen the amount of therapeutic time needed to process and resolve traumatic memories. Developed by Francine Shapiro, this technique requires training and following of specific protocols for appropriate use. For more information, contact:

EMDR Centers

P.O. Box 141743 Austin, TX 78714-1743

(512) 451-6944 (to obtain a referral in your area).

Treatment for Borderline Personality Disorder: Dialectic Behavioral Therapy (DBT)

Although the term
borderline personality disorder
is sometimes con- sidered pejorative, there is no question that people (mostly women) who carry this label are highly distressed and in a great deal of emo- tional and even physical pain. Regardless of what you believe about the label of borderline, the skills developed by Marsha Linehan to treat this disorder are highly effective. The people who commit to doing the skills training offered in dialectic behavioral therapy (DBT) groups get better. Most mental health centers now offer these groups. Refer to Linehan’s
Skills Training Manual for Treating Borderline Personality Disorder
(New York: Guilford Press, 1993) for more infor- mation on this form of therapy.

References

our parents as mirrors
Loring, Marti Tamm,
Emotional Abuse: The Trauma and the Treatment
(San Francisco: Jossey-Bass, 1998).
Napier, Nancy,
Recreating Your Self: Help for Adult Children of Dysfunctional Families
(New York: W.W. Norton and Co., 1990).
Wisechild, Louise,
The Mother I Carry: A Memoir of Healing from Emotional Abuse
(Seattle, Wash.: Seal Press, 1993).
the seven types of negative parental mirrors

Golumb, Elan, Ph.D.,
Trapped in the Mirror: Adult Children of Narcissists in Their Struggle for Self
(New York: William Morrow, 1992).

Kaufman, Gershen,
Shame: The Power of Caring
(Cambridge, Mass.: Schenkman Publishing Co., 1980).

how mirror therapy works
Middleton-Moz, Jane,
Shame and Guilt: Masters of Disguise
(Deerfield Beach, Fla.: Health Communications, Inc., 1990).
rejecting your parents’ negative reflection
Brown, Byron,
Soul Without Shame: A Guide to Liberating Yourself from the Judge Within
(Boston: Shambhala, 1999).
emotionally separating from your parents
Brown, Byron,
Soul without Shame
.
Engel, Beverly,
Breaking the Cycle of Abuse
(Hoboken, N.J.: John Wiley & Sons, 2005).
Goleman, Daniel,
Emotional Intelligence: Why It Can Matter More than IQ
(New York: Bantam Books, 1995).
quieting and countering your inner critic