Stress & Mood Management. Building Self-Esteem. Course Slides. Keeping Yourself Safe. Reflections on the Previous Session

Transcription

1 Course Slides Stress & Mood Management Building Self-Esteem To obtain a copy of the course slides, log on to: Alternatively, smm@sssft.nhs.uk. Please do not send any other requests or queries to this address as it is not monitored by clinical staff Those without access to the internet can request a paper copy. Keeping Yourself Safe Sometimes difficult emotional problems can lead to feelings of despair, including thoughts about hurting yourself, ending your own life or hurting others. Please see your handouts for sources of support Info Cards are available on request Reflections on the Previous Session What was useful from last session? What did you try and how did you get on? Was there anything that you wanted to try? What got in the way of your change and how can you overcome that this time? Inclusion Thurrock 1

2 Session Aims To understand low self-esteem. To consider how low self-esteem affects us day to day. To learn techniques to improve selfesteem. To learn how to improve communication with others. What is Self-Esteem? Self-esteem is more than the qualities we assign ourselves or the things we believe we can or cannot do. It is the overall opinion and value we place on ourselves as people, be that good/worthwhile or bad/useless. Melanie Fennell writer of Overcoming Low Self-Esteem Self-esteem is accepting yourself, with all your strengths and weaknesses, whilst taking opportunities for self development. Christine Wilding CBT Therapist and writer of Beat Low Self-Esteem with CBT Self-esteem is a state of mind. It is the way you feel and think about yourself and others, and is measured by the way you act. Connie Palladino, Psychologist and writer of Developing Self-Esteem. Defensiveness Rejecting compliments Jealousy Fault finding Lack of eye contact What is Low Self-Esteem? Fear of failure Inferiority Common Characteristics of Low Self-Esteem Fear of rejection Difficulties communicating Tolerating people s unacceptable behaviour Giving more weight to your faults than your strengths Conformity Guilt Shyness Case Study: Pete Growing up Pete s father had instilled the importance of working hard at school. When Pete came home with anything less than an A grade, Pete s father would say he was disappointed with him. Pete believed he was stupid and not good enough. Pete s father hired a private tutor to help improve his grades which meant he was unable to play football with the other children. They teased him about this, calling him thick and a loser so Pete believed he was unlikeable. Pete learned that it was better not to try than risk being found out as stupid. As a result he would avoid anything that tested his intelligence or where he thought he was likely to be judged negatively. When Pete found himself in one of these situations he would feel anxious, sick and try to get out of the situation by making excuses. Inclusion Thurrock 2

3 The Cycle of Low Self-Esteem Situation Pete s Cycle of Low Self-Esteem Asked by colleagues to go Situation to a pub quiz Actual or perceived criticism or judgement Self-Critical Thoughts They Actual If I get only or the perceived ask questions me to go criticism because wrong they ll or judgement feel think sorry I m stupid and for won t me. like me No-one Self-Critical I m useless likes me at Thoughts quizzes anyway Lower self-esteem Depression & Anxiety Physical Sensations They I m probably useless and didn t want Lower me unlikeable self-esteem there anyway Depression Depressed Low mood & mood Anxiety Physical Lethargic, Feeling Sensations lethargic tearful Unhelpful Behaviour Unhelpful Makes Mopes excuse about Behaviour not the to house go to all the evening quiz Unhelpful Thinking in Low Self-Esteem Personalising taking responsibility for things that are outside of your control; assuming you are in the wrong without considering alternatives. Jumping to Conclusions by mind reading (thinking we know what others think of us) or fortune telling (predicting the future) Labelling assigning critical labels to yourself such as useless, worthless, hopeless and stupid. Global attributes that leave no room for change. All or Nothing Thinking thinking in black and white terms ignoring any grey areas. It is good or bad, success or failure. Mental Filter being more focused on what you are doing wrong or badly, rather than on what you are doing well. Demand Statements Thinking I should (or shouldn t), ought to and must. Puts pressure on ourselves and sets up unrealistic expectations. Social Comparison Comparing ourselves with other people and their opinions without benefit of a fair benchmark. Unhelpful Thinking in Low Self-Esteem Perfectionism Perfectionism is a collection of unhelpful thoughts and behaviours. Perfectionism is the belief that there is a right way to do things and that it is our duty to do it that way. By driving ourselves to be the perfect parent or do the perfect job can lead us to think we have failed if we deem we have not met those standards. This negative thinking begins to lower our self esteem. Often we set ourselves up to feel worse as rarely can we achieve perfection. Look out for demand statements, labelling and mental filtering in your thinking. Inclusion Thurrock 3

4 How to Build Self-Esteem Pete s Unhelpful Thinking Thought Challenging Developing Self Acceptance Situation Asked by colleagues to go to a pub quiz. Thought If I get the questions wrong people will think I m stupid and wont like me. Feeling Anxious 90% Positive Data Log I m useless at quizzes. I m useless and unlikeable. Improving Communication They only asked me to go because they feel sorry for me. They probably didn t want me there anyway. Depressed 60% Challenging Unhelpful Thinking Exercise One Is this a fact, or just a thought? Is there another way of looking at it? What would someone else make of it? What unhelpful thinking habit is this? What advice would I give someone else? What evidence is there that this thought is true? Where is thinking like this getting me? What are the pros and cons of holding this belief? How could Pete look at this differently? What could he tell himself instead that might be more helpful to him? Use Pete s thought diary in your handout to help. Inclusion Thurrock 4

5 Pete s Revised Thinking Pete s New Behaviours Feeling Thoughts If Anxious I get the questions wrong 90% people will think I m stupid and wont like me. I m useless at quizzes. I m useless and unlikeable. They only asked me to go because Depressed they feel sorry for me. 60% They probably didn t want me there anyway. Revised Thoughts Feeling I don t know if this is Anxious true, I don t know what the 40% questions will be. I could get something right on the night. I can t know everything People get things wrong from time to time, it doesn t mean they wont be liked. I wouldn t stop liking someone if they got something wrong. This is just a thought. They Depressed had enough for a team 20% without inviting me. Old Behaviours Mopes about the house all evening. Makes excuse not to go. New Behaviours Continues with his usual daily routine Attends the quiz and tests out his new revised thoughts. The only way for Pete to gain evidence to support his new thinking is by carrying out his new behaviours. Exercise Two Write down five positive qualities about yourself. How might low self-esteem be holding you back? If your self-esteem was higher How might you think differently? How might you feel differently? What would you do differently? Self Acceptance In its simplest form, self acceptance means accepting yourself fully for the person you are: the things you like about yourself and the things you do not. As a result, self-acceptance is something that you do. It is an active process that involves a willingness to experience both our thoughts and our feelings. Inclusion Thurrock 5

6 Self Acceptance Self Acceptance Ambitious Compassionate Selfish Modest Patient Good Listener Stubborn Careless Sarcastic Helpful Impulsive Generous Tactless Forgiving Questions to Identify Positive Qualities What do you like about yourself? (However insignificant it seems!) What are the positive achievements of your life so far? Have you maintained any friendships, had a job, been a parent or carer? Have you developed any skills related to your job, home life, leisure activities or interests? Do you know how to cook, drive, swim, sew, use a computer, do housework, gardening or DIY? Do you have any academic, artistic, sporting or people-skills? What would someone supportive of you say your qualities and strengths are? What qualities do you like in others that you also have? Positive Data Log Begin to evidence your positive qualities daily. Set yourself a target number of positive qualities to record each day; between 1-3 to start. Try buying a good quality notebook with an attractive cover to encourage you to record. Make sure your notebook is small enough to carry around with you. Eventually this process will enable you to acknowledge your good points automatically without writing them down. Inclusion Thurrock 6

7 Positive Data Log Communication and Self-Esteem Evidence of Positive Quality Colleagues invited me to a pub quiz Helped daughter with her homework Let another driver out of a side road Positive Quality Likeable Approachable Knowledgeable Considerate Passive Aim to avoid conflict and unpleasantness Benefits: Avoids or postpones conflict. Rarely blamed if things go wrong as takes no responsibility. Not seen as a threat. Aggressive Aim to dominate, get our own way and always win Benefits: Tend to get your own way. Can feel powerful and in control. People always know how you feel. Assertive Aim: To communicate clearly asserting our needs whilst respecting those of others Benefits: Prevent resentment building up. Standing up for yourself and acting in a manner you respect. Higher self-esteem. Put a donation in charity collection box Changed the plug on the strimmer Kind Compassionate Competent Skilled Costs: Can encourage unhealthy relationships. Can be prone to build up stress/anger which can lead to aggression. Loss of self esteem. Costs: Feelings of guilt/shame. Can create resentment in others. Difficulty relaxing. Anxiety. Loss of self esteem. Costs: Others may have benefited from your lack of assertiveness and may react. Communication and Self-Esteem Most communication is non-verbal. Dr. Albert Mehrabian found that 7% of any message about feelings or attitudes is conveyed through words, 38% through tone of voice, and 55% was nonverbal (e.g. facial expressions, gestures, posture). Being assertive helps to acknowledge our strengths and to recognize when we have done something well. It aids in improving our self-esteem and our self-confidence. Assertiveness is about respecting and valuing ourselves; recognising that we have the same rights and self-worth as everyone else. In acting assertively, we reinforce that belief and increase our self-esteem. The Bill of Rights 1. The right to ask for what we want. 2. The right to express our feelings, opinions and beliefs. 3. The right to make our own decisions and to cope with the consequences. 4. The right to say 'yes' and 'no' for ourselves. 5. The right to change our minds. 6. The right to say I don't understand. 7. The right to choose whether or not to get involved in the problems of someone else. 8. The right to make mistakes. 9. The right to be alone and to be independent. 10. The right to privacy. 11. The right to be successful and to acknowledge it. 12. The right to change ourselves and be assertive people. Inclusion Thurrock 7

8 I-Language Assertion Describe the behaviour: When you, How it affects you: it affects, Describe your feelings: and I feel ; Describe your desire: therefore, I would like. When you shout at me I am unable to work with you and I feel angry. Therefore, I would like you to stop shouting and tell me what you want. Basic Assertion: making a statement that expresses our needs, wants, thoughts or feelings. I would like to speak to you about this problem. I feel angry about this issue. Empathic Assertion: Understanding and acknowledging the other person s point of view as well as a statement of your needs and wants. I appreciate that you don t like the new procedure, however until it s changed, I d like you to keep working on it. Consequence Assertion: This is the strongest form of assertion and is seen as a last resort. When you use consequence assertion you inform the other person of the consequences for them of not changing their behaviour. "If this occurs again, I'm left with no alternative, but to apply the formal disciplinary procedure. I'd prefer not to." Inclusion Thurrock 8

9 More How to use all three effectively: "I bought this lampshade here yesterday. When I opened the box, I noticed it had a crack in it so I'd like to exchange it please. (Basic Assertion) At this point the assistant will either agree or say: The lampshade should have been checked before it left the shop. "I realise that it would have been a good idea to have checked the lampshade before I left the shop, however, I would still like it to be replaced. (Empathic Assertion) At this point the assistant will either agree or say: "I don't have the authority to exchange things. "I would like the lampshade exchanged. If you are not prepared to do that I will take the matter up with your Head Office. I would prefer to resolve it now. (Consequence Assertion) Start with practicing basic assertion skills first. Offer solutions rather than problems. Try not to bring up past grievances. Remember non-verbal communication. Practice your assertiveness skills in minor situations first. This will build selfconfidence for more difficult circumstances. Review of Session Aims To understand low self-esteem. To consider how low self-esteem affects us day to day. To learn techniques to improve selfesteem. To learn how to improve communication with others. Home Practice Between now and next session we suggest you: Add learning points to your recovery blueprint. Continue completing thought records and challenge your thinking. Change your behaviour to support your new thinking. Start keeping a Positive Data Log. Practice being more assertive. Check out the additional resources on the website. Remember to log on and complete feedback about this session at Inclusion Thurrock 9