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2 Treating Intrusive Thoughts and the Inner Critical Voice 2

3 Course Outline Basic Understanding: the Inner Critical Voice and Intrusive Thoughts Moderate Intervention: The F.E.A.R. Model Recovery Steps In-depth Intervention: The 3 Psychological Elements for Recovery Q & A Session 3

4 Session 1 4

5 Basic Understanding: Intrusive Thoughts & the Inner Critical Voice 5

6 Intrusive thoughts and the inner critical voice are the biggest breeders of many anxiety-related disorders. 6

7 Intrusive Thoughts 7

8 What Is Intrusive Thoughts? Intrusive thoughts are uninvited and unwanted thoughts, images or perverse ideas that are distressing, unsettling and generating huge anxiety in the process. 8

9 3 Main Categories of Intrusive Thoughts 1. Inappropriate Sexual Thoughts 2. Inappropriate Violent Thoughts 3. Blasphemous Religious Thoughts 9

10 The Inner Critical Voice 10

11 What is the inner critical voice? The inner critic or the critical inner voice is the inner-chatterbox that relentlessly attacks a person s mind, causing shame, guilt, fear, inferiority and anxiety. 11

12 5 Building-Blocks For GAD & Panic Attacks #1:Your life experience. #2:Your pattern of thoughts. #3:Your feelings. #4:Your physical symptoms. #5:Your avoidance mechanisms

13 The 5 Building Blocks for Anxiety-Related - Denial, Social Withdrawal, Repression, Intellectualisation, Life Experience Fear, Guilt, Inferiority, Anger Avoidance Mechanism Physical Symptoms Pattern of Thoughts Feelings Catastrophic thinking, Habitual negative thinking, Rumination, Worrying 13 Panic attacks, Faintness, Shortness of breath, Heart palpitations, Sweating, Dizziness, Nausea Anxious, Panicky, Nervous, Ashamed, Depressed, scared

14 The Stress Scale (Top 7 most stressful life events) By Dr. Richard Holmes and Dr Thomas Rahe (SRRS) #1: Death of spouse #2: Divorce #3:Marital separation #4:Jail term #5:Death of close family member #6:Marriage #7:Redundancy

15 Activity 1. Take one of the life events from the Stress Scale. 2. Using the 5 building blocks for anxiety, guess a client s potential reactions to your chosen life event; Pattern of thoughts, Feelings, Physical Symptoms, Avoidance mechanism. The Stress Scale #1:Death of spouse #2:Divorce #3:Marital separation #4:Jail term #5:Death of close family member #6:Marriage #7:Redundancy 5 Building Blocks #1: Life Experience #2: Pattern of Thoughts #3:Feelings #4:Physical Symptoms #5:Avoidance Mechanism

16 The 5 Building Blocks for Anxiety-Related - Denial, Social Withdrawal, Repression, Intellectualisation, Life Experience Fear, Guilt, Inferiority, Anger Avoidance Mechanism Physical Symptoms Pattern of Thoughts Feelings Catastrophic thinking, Habitual negative thinking, Rumination, Worrying 16 Panic attacks, Faintness, Shortness of breath, Heart palpitations, Sweating, Dizziness, Nausea Anxious, Panicky, Nervous, Ashamed, Depressed, scared

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18 Session 2 18

19 Moderate Intervention: The F.E.A.R Model (Part 1) 19

20 Treating Generalised Anxiety & Panic Attacks The F.E.A.R. Model: Step-By-Step Recovery Guide 20

21 The F.E.A.R Model 1. F.for Flip 2. E.for Envision 3. A.for Advance 4. R.for Relax

22 The F.E.A.R Model 1. F for.flip What do you flip or turn over? 1. Dominant Intrusive Thought (DIT) 2. Dominant Inner Critical Voice (DICV)

23 1. F.for..Flip The F.E.A.R Model Steps for effective Flipping: Identify any active intrusive thoughts and inner critical voice. Write them down. Identify the dominant intrusive thought (DIT) or inner critical voice (DICV). Flip it. Turn the identified DIT (or DICV) into a positive statement. Write it down as though you are already experiencing it.

24 The F.E.A.R Model Activity Get yourself a partner (client/therapist role play). Write down 3 intrusive thoughts or inner critical voice that you have experienced in the past 12 months. Therapist asks the client the following questions: From your list, which one do you consider as your DIT or DICV? Swap roles. What positive statement can you flip this into and why? How can you construct your positive statement as if you are already experiencing it?

25 The F.E.A.R Model 2. E..for. Envision Envision the new Positive Statement as though it is already your reality. The subconscious mind creates our habits and belief system based on what we do, think or say repetitiously. Likewise, the brain reconstructs itself in accordance to our dominant thoughts, actions and words. By constantly visualising your new positive statement, you authorise the brain and the subconscious to start a positive restructuring process. Repetition is the code to the subconscious reconditioning. Talk and think about your positive statement all the time.

26 The F.E.A.R Model Activity Get yourself a DIFFERENT partner (client/therapist role play). Therapist gives the client the following instructions: Sit comfortably and close your eyes. Breathe in and out 5 times deeply and slowly, while imagining your entire mind and body relaxing. Now, begin to envision your new positive statement unfolding in your imagination. Countdown from 5 to 1 and ask the client to open his/her eyes. Swap roles.

27 Session 3 27

28 Moderate Intervention: The F.E.A.R Model (Part 2) 28

29 The F.E.A.R Model 3. A..for. Advance This simply means, face your fears. Steps to facing your fears: Write down all the fears you are currently nursing as a result of your DIT or DICV. Write down all the different ways you have been avoiding your fears. Write down everything you can start doing in order to stop avoiding your fears. Pick one thing you can start doing from the list, then use Imaginary Desensitisation (ID) to advance. Once comfortable with the ID, try Real Desensitisation (RD).

30 Activity Write down one fear that you are currently nursing as a result of your DIT or DICV. Write down one way you have been avoiding this fear. Write down one action-step you can start taking to stop avoiding this fear. Get yourself a DIFFERENT partner (client/therapist role play). Therapist gives the client the following instructions: Sit comfortably and close your eyes. Breathe in and out 5 times deeply and slowly, while imagining your entire mind and body relaxing. Envision your new positive statement. Now, see whether or not you can move towards what you have been dreading of facing. Countdown from 5 to 1 and ask the client to open his/her eyes.

31 The F.E.A.R Model 4. R..for. Relax Relax means lack of response to intrusive thoughts or the inner critical voice. The best way to relax is to constantly engage the F.E.A.R Model in your mind. Master simple relaxation exercise to regularly engage the F.E.A.R. Model. Always identify any developing DIT or DICV. Make the F.E.A.R Model part of your daily routines. If done regularly, the brain and the nervous system will eventually destroy the old anxiety pathways and build a new one for calm.

32 The F.E.A.R. Model for Treating Intrusive Thoughts and the Inner Critical - Relax means Do Not Respond to Any Developing Intrusive Thought or Inner Critical Voice. Always identify any developing negative thoughts or inner critic. Always take them through the F.E.A.R. Model. Make the F.E.A.R Model your daily mind practice. Relax Write down all the fears you are nursing currently (List 1). Write down different ways you ve been avoiding these fears (List 2). Write down everything you can start doing to STOP avoiding your fears (List 3). Pick one thing from list 3 that you can start attempting to advance toward. Advance toward this fear first in your IMAGINATION. Once comfortable in the imagination, attempt to approach the object of your fear in REALITY. Flip The End The F.E.A.R Model Advance 32 Write down your top 3 intrusive thoughts or inner critical voices. Identify the dominant one. Flip your Dominant Intrusive thought & Inner Critical Voice to a positive statement. Write it down as though you were already experiencing it. Envision Sit comfortably and close your eyes. Breathe in and out 14 times and imagine your entire body relaxing. Envision your new Positive Statement. Let your imagination run wild. Create a perfect scenario where you are living your positive statement. Get your feelings and emotions involved. Connect and enjoy the feeling and the moment. Countdown from 5-1 to open your eyes.

33 Session 4 33

34 In-depth Intervention: The 3 Psychic Elements for Recovery 34

35 3 Elements of the Human Psyche for Anxiety Recovery 1. The Emotional Brain: This is the part of the human psyche that is responsible for protecting you from pain. It s known as the Main Protector. 2. Repressed Negative Emotions: Repressed negative emotions are the emotional pains generated from distressing experiences of your past or present which still remain unprocessed. Repressed negative emotions are referred to as Exiles-In-Pain. 3. The Self: This is your true self that, if connected with, has enormous ability to heal and eliminate the burdens that other elements of the psyche carry. The Self is the natural leader within the elements of the psyche. 35

36 How Anxiety-Related Disorders (Outlets) Are Generated To maintain sanity, repressed negative emotions in the subconscious mind must not explode into the conscious mind. The emotional brain (the main protector) must find a way to reduce the level of your repressed negative emotions in the subconscious. The emotional brain achieves this by generating outlets where repressed negative emotions can be diverted and expressed. These outlets are various anxiety-related disorders, including intrusive thoughts and the inner critical voice. 36

37 Group Exercise 1. One participant brings an anxiety issue to the table (issue not more than 7 years old). 2. Attempt as a group to resolve this issue using the F.E.A.R Model Recovery Steps.

38 The F.E.A.R. Model for Treating Intrusive Thoughts and the Inner Critical - Relax means Do Not Respond to Any Developing Intrusive Thought or Inner Critical Voice. Always identify any developing negative thoughts or inner critic. Always take them through the F.E.A.R. Model. Make the F.E.A.R Model your daily mind practice. Relax Write down all the fears you are nursing currently (List 1). Write down different ways you ve been avoiding these fears (List 2). Write down everything you can start doing to STOP avoiding your fears (List 3). Pick one thing from list 3 that you can start attempting to advance toward. Advance toward this fear first in your IMAGINATION. Once comfortable in the imagination, attempt to approach the object of your fear in REALITY. Flip The End The F.E.A.R Model Advance 38 Write down your top 3 intrusive thoughts or inner critical voices. Identify the dominant one. Flip your Dominant Intrusive thought & Inner Critical Voice to a positive statement. Write it down as though you were already experiencing it. Envision Sit comfortably and close your eyes. Breathe in and out 14 times and imagine your entire body relaxing. Envision your new Positive Statement. Let your imagination run wild. Create a perfect scenario where you are living your positive statement. Get your feelings and emotions involved. Connect and enjoy the feeling and the moment. Countdown from 5-1 to open your eyes.

39 Further Reading John E. Sarno, MD: (Professor of Clinical Rehabilitation Medicine, New York School of Medicine Publication: The Mindbody Prescription Norman Doidge: (Psychiatrist, psychoanalyst and researcher (Columbia University and University of Toronto) Publication: The Brain That Changes Itself Richard C. Schwartz, Ph.D.:(Pioneer of the Internal Family Systems Model (IFS) Publication: Internal Family Systems Therapy 39

40 Treating Intrusive Thoughts & Inner Critical Voice The End 40

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