412: Ask David: Give-Get Imbalance; Best Anxiety Treatment; Externalization of Voices; and more

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What's a Give-Get Imbalance?

What's the Best Treatment for Anxiety and Dysthymia?

Can you do Externalization of Voices on Your Own?

The show notes for today’s podcast were largely written prior to the show. Tune in to the podcast to hear the discussion of these questions by Rhonda, Matt, and David.

And keep the questions coming. We enjoy the exchange of ideas with all of you. Thanks!

1. Suzanna asks: What’s a “Give-Get” imbalance? And how can you get over it?
2. Martin asks: What’s the best treatment for anxiety and dysthymia?
3. Eoghan (pronounced Owen) asks: Can you do Externalization of Voices on your own?

 1. Suzanna asks: What’s a “Give-Get” imbalance? And how can you get over it?

Description of Suzanna’s problem.

Suzanna is a woman with a grown daughter with severe brain damage due to a severe brain infection (viral encephalitis) when she was an infant. Suzanna was constantly giving of herself and catering to her daughter. She explains that her daughter can be very demanding and throws tantrums to get her way, and kind of controls the entire home in this way.

She can only talk a little and has the vocabulary of about a two-and-a-half-year-old. She can mostly express the things she wants or doesn`t want on a very basic level. She mostly understands what I want from her, but mostly does not want to do what I ask her to do. She can be very stubborn. And I cannot reason with her because she has her own logic and, in her eyes, only her logic is valid. Maybe all a little bit like a two-and-a-half-year-old.

Suzanna struggles with negative feelings including guilt, anxiety and depression, because she is constantly giving, giving, giving and feeling exhausted and resentful. And she tells herself, “I should be a better mum.” Can you spot any distortions in this thought?

Put your ideas in the text box, or jot them down on a piece of paper, and then I’ll share my thinking with you!

What are the distortions in the thought, “I should be a better mum”?

There are many distortions in this thought, including All-or-Nothing Thinking, Overgeneralization, Mental Filtering, Discounting the Positive, Magnification and Minimization, Emotional Reasoning, Self-Directed Should Statements, and Self-Blame. There may be one or two more, too!

The first step in change nearly always includes dealing with motivation and resistance. Suzanna decided to do a Cost-Benefit Analysis, as you can see below, and a revision of her Self-Defeating Belief, as you can see below.

Another helpful step might include “No Practice,” which simply means saying “no” so you don’t constantly get trapped by “giving,” as well as “giving in.”

A third critically important strategy involves the mom and dad making the decision to work together as a loving team in the management of a troubled child, rather than fighting and arguing with each o