The road to earning my master’s degree in social work (MSW) was long and painful. I had numerous bad experiences in schools of social work along the way. I have posts and/or whole blogs devoted to certain aspects of that experience: the worst part. continuing for years, at Indiana University; a terrible first year at the University of Missouri – Columbia; and a dismaying experience at the University of Michigan.
Those experiences drove me to speak out on some of the things that happened during those years. The blogs that describe some of those experiences — including my blog about social work education generally and about mistreatment of men in schools of social work — demonstrate serious problems in the training of social workers. No doubt I will continue to develop those blogs from time to time.
Meanwhile, though, I want to open another dimension on those sorts of experiences. The fact is that people in situations like mine do not merely endure an educational ordeal: there is emotional damage as well. Nor is the phenomenon limited to educational contexts. I realize that graduate programs differ from traditional workplaces in many ways. But for the person on the receiving end of abuse from someone in a position of power, it feels much the same, regardless of whether that other person is your employer or your professor.
In a course at Missouri taught by Dr. Kim Anderson, I had an opportunity to describe some of what I was experiencing emotionally. Kim assigned us to perform a self-assessment, using something called the Dysfunctional Thought Record (DTR). There does not appear to be a lot of professional research on the DTR, so I cannot say whether it is especially useful in clinical practice; but for whatever reason she wanted us to use it, and so I proceeded with the writeup that she assigned.
This post provides the text of that writeup. It is a long document. For this, I make no apology: emotions are often complex, and describing them can require patience. I expect this post to be of interest primarily to people who want to explore emotions. I could rewrite the document to be much briefer now, but I have decided to just provide what the actual assignment called for, and what I wrote at the time.
There is always the possibility that some person of hostile intent will read this material in search of something that might cast me in a disfavorable light. I guess repeated experiences with persons of that nature, in social work education, have left me less concerned about them than I used to be.
To summarize events leading up to this writeup, Drs. Larry Kreuger and Wilson Watt had pursued a formal effort to get me thrown out of the School of Social Work. There was no basis for their effort. It was pure harassment. At this stage of the matter, I was being called in to meet with the university’s provost about it.
As it turned out, the provost and I had a ten-minute conversation. That was how long it took him to conclude that those professors were completely out of line. He dismissed the charge against me and said he was going to speak with the people at the School of Social Work. But that meeting had not happened yet, when I was preparing the following writeup. At this point, I was facing the threat of an unknown result, along with a lot of emotions.
In case you wonder, Kim did not offer to speak with me about the emotional situation described in my paper, and to my knowledge did not take any other action on it. Readers may differ on the question of whether a professor should speak out when s/he learns that a student is being abused. But in this case, it’s not a matter of opinion. There were many violations of the social work professional code of ethics, and Kim was participating in some of them. For instance, it was a violation to fail to uphold the profession’s values. She functioned as part of the clique, when I, or anyone, would have appreciated having at least one professor on their side. Sadly, in my reading and experience, social work professors very rarely display that kind of courage. They do seem ready to express concern for a student’s complaint (even a complaint that is palpably manipulative), though, if the student is a female, complaining about a male.
After the provost’s decision, none of the social work professors or administrators who had participated directly or indirectly in that harassment apologized, communicated relief or encouragement on my behalf, or otherwise offered any support. I ceased to participate in the Missouri social work program after that semester.
As I review Kim’s assignment and my writeup now, years later, I find it rather remarkable. In the following document, I was providing a clinical self-dissection of an extraordinarily unfair and upsetting experience, and Kim was sitting there reading it. There was something Kafkaesque if not slightly Mengelian about the situation. I was a sort of insect that seemed to be having difficulty — an object of passing interest or perhaps entertainment.
The text of the assignment follows. The bold text presents Kim’s assignment; the regular text contains my response.
* * * * *
SW7770 Case Assignment #2
Assignment is to be type-written and double-spaced. Due Date: 3/30. Select an event that led to an unpleasant emotion for you. Select an event that you will be able to do an in-depth dysfunctional thought record on for your assignment. (75 points).
1. Complete the Dysfunctional Thought Record (DTR) form on the selected event. This can be handwritten onto the form. (See supplemental reading on ERES that addresses evaluating automatic thoughts.)
(I have adapted the questions from the DTR form to fit here, so that I can type the answers rather than handwrite them. In writing these paragraphs, I am slipping between present and past tense, in a bid to preserve the original raw material from March 20 along with my subsequent comments on it.)
Choose one situation that impacted your automatic thought(s) and complete the following Dysfunctional Thought Record.
I want to address a situation that has generated thoughts that, at this moment, are quite powerful for me. In exercises in other classes, some students have used made-up situations rather than real-life scenarios of real significance to them personally. I have noticed that such students have not seemed to become very engaged with the exercise. In the interests of learning as much as possible from the current assignment, I am describing a situation of intense personal meaning. Doing so has the unfortunate byproduct of generating a lot of material, and making a lot of extra work for both me and the reader. But it is an interesting situation, and I hope the reader will find it interesting.
The situation that I have chosen for this assignment arises from today’s (March 20) experience of anticipating a meeting, sometime this week, with the Provost regarding Dr. Kreuger’s complaint against me. It goes without saying that, in providing the following information, I am placing considerable trust in the reader’s integrity and sense of confidentiality.
DTR Heading: Situation
What actual event or stream of thoughts, or daydreams or recollection led to the unpleasant emotion?
The Provost indicated by e-mail that he expects me to come into his office and meet with him this week. I have been amenable to that. The upsetting part is that he expects this even though, to my knowledge, there is no charge against me that might warrant calling me on the carpet. From the materials available to me, plainly Dr. Kreuger is upset, but he seems to have withdrawn his earlier rant about academic dishonesty. So I do not understand why this matter lives on.
What (if any) distressing physical sensations did you have?
Tension. Nothing specific, physically; just tension. For a while, I might have experienced some narrowing of my field of vision, as I became focused on the computer keyboard on which I relied to deal with this upsetting situation.
DTR Headings: Automatic Thought and Emotion
What thought(s) and/or image(s) went through your mind, and how much did you believe each one at the time? (0-100%) What emotion(s) did you feel at the time, and how intense was the emotion? (0-100%)
The situation just described generated a flood of thoughts and emotions. Certainly I understand that one word (e.g., illogical) might refer to thoughts, while another word (e.g., fearful) might refer to emotions. But it would be unrealistic to proceed as though the words controlled the reality. In my actual experience, I did not find that thoughts and emotions flowed in easily distinguishable channels.
Therefore, for purposes of understanding how to apply the DTR to actual clients, it seemed advisable to begin where the client is – with, that is, where I myself was. I was in a situation in which thoughts and emotions were mingled and were interacting with and reacting against one another.
According to the distributed pages of Judith Beck’s book, Cognitive Therapy: Basics and Beyond, some patients, “despite the best efforts of their therapist, cannot or will not write down their thoughts and so rarely use” the DTR; also, “a patient may be overwhelmed by the format of the DTR” (p. 125). I am, perhaps, one such patient. As just described, I did not find the DTR very helpful, particularly at the outset, and particularly in regard to its black-and-white distinction of thoughts and emotions. (This comment, and other comments on the process, were added to this text on March 21 and 22.) In my experience in this particular case, emotions triggered thoughts and also arose from thoughts. As the reader will soon see, a precise cataloging of those interactions, in this case, would impose an overwhelming clerical task. (Beck (p. 135) anticipates this.)
To convert my flood of thoughts and emotions into manageable form, I decided to begin by simply summarizing what I was experiencing. This, I think, would be analogous to the introductory conversation with the client, in which we might discuss, to some extent, the nature of the basic problem. I organized this summary of my experience under six major headings, as shown below. Those headings are Suspicion, Fear, Humiliation, Dismay, Disgust, and Distrust. I produced those headings in that order. For example, I wrote Suspicion as one of the first things that came to mind; I described that aspect of my situation in mixed terms of thought and emotion; and then, when I realized that I was experiencing something else in addition to suspicion, I ended that paragraph and started with another heading. Collectively, I am going to thought-emotion clusters first, I am proceeding consistently with Beck’s indication that the columns of the DTR do not need to be filled out in order (p. 130).)
After writing the last of those six headings, I decided to write an e-mail message to the Provost. In the process of deciding what to say, I became aware of a second set of thoughts and emotions. I did not seem to have been immediately in touch with these, unlike the first set. Relatedly, I did not have as clear a grasp of their content. The headings that I came up with, within this second set, were Lack of Control; Flight/Refugee Status; Loneliness/Grief/Despair; and Anger. These comprise the Second Set of Thoughts and Emotions.
To move from that raw description to the concept of Automatic Thoughts, I went through several steps, as follows:
First, I think what happens, in this process, is that I am immediately intellectualizing my emotional reactions, to the extent I am able. That, I think, is what was happening as I generated the First Set. Then I begin to process the implications of those emotions in real-world terms. That is, I am then trying to figure out what will actually be happening, in my life, as a result of the new intellectual-emotional interpretation. That seems to be, roughly, the nature of the Second Set. It is, in essence, a look at the new realities, through the standing filters that I have named: suspicion, fear, distrust, and so forth.
When I saw that those filters were negative, my first reaction was that perhaps I simply use negative filters for negative experiences. But Kuehlwein (in chapter 6 of the Dorfman book, p. 132) describes the cognitive approach as asserting that this orientation toward the negative is part and parcel of the disordered schemas that need to be corrected.
The Second Set is relatively unknown to me, I think, because it represents the deeper fears, or it holds the worst-case scenarios that I was initially unwilling to confront, or that I might have hoped I would not have to awaken, but against which I now feel I must compare the conclusions I reached in the First Set.
(This way of looking at things poses the incidental thought that perhaps a given descriptor (e.g., Suspicion) is useful or applicable, not on some absolute, abiding basis, but rather according to the timeframe: it may have described an emphemeral state of mind or heart that seemed predominant at one point but merely illustrative or historical, or altogether tangential at another. Later, for example, I might have said that the problem I was experiencing was not really Suspicion but was, rather, Grief or something else from the Second Set.)
In light of the foregoing, it is interesting to contemplate Kuehlwein (p. 131), who says that, according to Beck, cognition is primary vis-à-vis emotion. The previous discussion suggests that, in my experience, cognition is primary, but only in the sense of being the tool that I hasten to apply to these enormous cauldrons of molten emotion. The cognitive tool may be relatively flimsy – those cauldrons would bend or melt it, if I expected this tool to carry and control, by itself, their extremes of weight and temperature – but as long as I understand that cognition is merely a tool, and do not confuse it with the weighty, overheated content, I might be able to use it to manipulate those cauldrons pretty well.
With that, I turn to the task of describing the thoughts and emotions in question. The reader may get the picture just by reading the summary headings, but I needed to describe them in more detail in order to remember, for purposes of subsequent review, what they felt like at the time. My writeup of those clusters of thought and emotion, prepared on the evening of March 20, was as follows:
First Set of Thoughts and Emotions
Suspicion. It is not that I know, or even think, that the Provost is out to get me. But he ignored my inquiry about applicable rules a couple of weeks ago, before I even knew that he was the Provost. That is, I had posed some questions to another person back then; that person had thought that this guy would have the answers; I contacted this guy; and he ignored me. Did he know, at that time, that this matter would be coming his way – and, if so, how? Who has he been talking to? Or was he not particularly interested in the question that I posed to him, such that my case is now a mere annoyance?
My suspicion, like the other thoughts discusssed below, fluctuated during the time in question, which was most of this afternoon (March 20). That is, I was preoccupied with this matter for several hours at least. To varying extents, I plainly have strong opinions on each of these points (i.e., suspicion, fear, etc.). On the topic of suspicion, I am pretty trusting and/or am inclined to search for the positive or the rationalization. So while I did tip over the line into genuinely doubting the Provost for a while, I probably believed this one less than 50% most of the time today. (As suggested above, that percentage is a moving target, in that the original concern (e.g., Suspicion) seems less important as I move on to second-level concerns – so that, at this writing, several days later, I would not have written about Suspicion first. and probably would have assigned it a lower percentage.)
Fear. The Provost is a law professor; what abusive concept of fairness might have seized hold of him during his years of practice? He is, essentially, my judge; there are all kinds of judges; and you always have to be afraid of what screwball things they are going to think, say, or do. Power tends to corrupt. Posner (a well-known judge whose book on jurisprudence I paraphrased, some years ago, in an attempt to understand his concept of justice) taught me that even the most highly respective judges have some very destructive ideas. The fact that this guy got irritated with me, just for asking some pretty straightforward questions about the process, makes me worry that he only wants to get me in there so that he can savage me according to some preexisting agenda. [I had had that kind of experience with judges while practicing law.] It goes right back to childhood, with my physically and psychologically brutal father holding a huge hand next to my face and threatening to hit me if I refuse to admit that I did something wrong that, in fact, I did not do. The terror was devastating – it was far worse than the actual impact, which rarely came. I did genuinely fear the Provost today, but not at all to the extent that I have feared some persons in positions of judgment. I would give this one around two-thirds, i.e., 67% – which is to say, odds are about two to one that I will have a bad experience in being judged.
Humiliation. A few weeks ago, I was the only male being inducted into the Phi Alpha honor society; now I am a bloody criminal. Dr. Watt wanted to lord it over me, working out his own anger at lawyers and incorrigibly assuming that I deserve to be treated as a target of his wrath; and the system (and my School) is totally standing behind that abusive man. He is the only one who is accusing me of academic dishonesty at this point; he has not even heard my side of it; but on the basis of his insertion of his own views into the matter, the Provost has a pretext on which to threaten me with severe punishment if I do not bow down to arbitrary authority. This is happening when nobody has specified anything, in my actions, that amounts to wrongdoing of any kind. I am nearly 50 years old and I am being treated like a bad little boy, by self-styled grownups who seem to be motivated by their issues, not mine. The childhood experience of being ridiculed in front of others has stayed with me; there is, all too often, some way or other in which this sort of experience winds up going in that direction. But I have gotten so used to this nonsense that it has lost some of its edge. This one was probably in the 60% intensity range today.
Dismay. The subtext is that I offended Dr. Kreuger by upsetting business-as-usual in his classroom, which consists of administering quizzes whose answers are ambiguous and confusing (and sometimes not even intelligible, due to typographical errors) in a way that just begs students to be tempted to cheat. And then he pretends not to understand how changing the quiz questions would reduce cheating! Dr. Kreuger is angry at me, specifically, because I have unwittingly forced him to change the quiz questions for once in God knows how many years; otherwise, students would have continued to be free to pass down the answers from last year to their friends this year, and so on, thereby helping the dishonest students at the expense of the honest. My preliminary research suggests that nobody thinks this is a good teaching practice. Yet Dr. Kreuger has the temerity to wrap himself in the raiment of the holy, looking down on me for being in some sense morally lacking. I was doing his job for him, trying to help students who are attempting to test out of the course, when he could not be bothered to give them any guidelines as to what they should study for the test-out exam; yet somehow I wind up getting the punishment – and at his behest. The injustice of it brings immediately to mind another childhood scenario, of being blamed for every dispute with my younger sister, no matter how egregious her behavior. This is the logical argument, and I don’t think Dr. Kreuger has a leg to stand on, so I guess I am in the vicinity of 90% here.
Disgust. Social workers are not going to stand for their principles when it is dangerous to do so, if they do not even have the courage or initiative to stand for their principles when doing so would be relatively easy. I am finding myself thinking something that, a year ago, I would have considered unthinkable – that lawyers might actually be more principled than social workers. To my knowledge, not a single one of the faculty members responsible for this process has striven to make it a fair process, conducted by the School’s own rules and in accordance with their professional obligations. Then again, since I doubt that most people are as righteous as they like to believe, including myself, I am not entirely confident that I belong in a position of disparaging others for their cowardice, about which I could conceivably be wrong (though I doubt it) and in which I might not be any better (though I think I am, as evidenced by the fact that I am able to stand up against this establishment). I am also generally suspicious of self-praise, and I think I might have a different opinion if I had more information. So I probably believed this one somewhere around 55-65% today.
Distrust. I was Dr. Kreuger’s star student, getting the highest score in his research class last year. He loaned me books on qualitative research. I solicited his friendship. If he can turn against me like this, despite my very sincere and repeated apology, for no reason other than that I unintentionally made him do some extra work; and if all these other platitudinal professors can dump me and their own alleged principles at the drop of a hat; and if, as I have been denying to myself all year (but as now seems to be the case), a substantial number of my classmates would not dream of standing up for one another – if this is the nature of the beast, then one side of me says that I had better learn the rules of the game, close in, and treat it as every man for himself. But that harks back to the topic of disgust; I really don’t want to be like that, and I don’t think that, ultimately, I will need to; so I imagine this one is around 40%.
Second Set of Thoughts and Emotions (prepared an hour or two later)
Lack of Control. I mean this as an emotion in the sense that fear of falling is an emotion. It is a raw, gut instinct. Lack of control means that, because things aren’t going ideally, the foregoing clusters of thought and emotion are getting triggered. It is as if I slipped off the tightrope and am now falling through a whirlwind filled with demands, reactions, rules, and other flying debris that, collectively, is stripping away my preferred sense of balance – my sense that I am proceeding where and how I wish. The realization that I was going to have to go see the Provost, totally exposed, without any clear reason for why I had to do so, and with the humiliation of having been abused again by the father-like Dr. Watt – this brought to mind the awareness that this might be another one of those experiences where someone is going to wreck my world, according to some through-the-looking-glass rationale that makes no sense but that no one will permit to be seriously challenged. While I can show some uncertainty about the foregoing thoughts (e.g., those related to suspicion), there is no denying that I spent several stressful hours of my afternoon writing a letter that will not be sent and otherwise wrestling with this frightening reality, in a bid to somehow get my arms around it or deal with it. I think the intensity of this particular thought or feeling was probably about 90% today.
Flight/Refugee Status. This, too, is a gut instinct underlying some of the foregoing, relatively cognitive reactions. Here, you come face-to-face with the extremes. I think what makes these seem more emotional is that they are not assertions of e.g., overly pessimistic fact; they are, rather, better posed as questions – as unplanned, random explorations of the vast realm known as Worst Case. Like, Why don’t I just give up? What if I drop out of school? What if I am forced out? What if the Provost puts a hold on me, so that I cannot register for classes this autumn? What if he puts some kind of permanent stain on my record? What if these professors really are all plotting against me, or laughing about me behind my back? What if they, or perhaps only a cunning, gossiping minority of them, have set up a scheme to ensnare me, so as to get me thrown out of the school at the end where they somehow failed to prevent me (a lawyer, a Euro male, someone with weird ideas, someone who is full of himself, or whatever their stereotype might be) from getting into the school in the first place? What if, after all these years, the career that I have finally come back to school to earn is taken away from me? Will I become homeless? Will I die? This general Flight/Refugee item, like the one describing Lack of Control, is a distillation of the worst-case scenarios of several of the thought-emotion clusters identified earlier. Like a predator, higher on the food chain, the poisons tend to accumulate here in more toxic concentrations. Since I did not seriously flirt with immediately packing up and heading for the coast, China, or Mars, I can’t give this one 100%, but it does describe the nagging category of undesirable outcomes that reminds me of a potentially unbearable, essentially hopeless life situation that I have left behind and do not wish to return to. I guess this was probably around 65-75% today.
Loneliness/Grief/Despair. I have worked so hard to become, at last, a success in something. I have wanted to believe in it. It is turning out so awful, and the people are seeming so horrible. I am alone in this thing, and as I get older and, in many eyes, more ugly, scary, and generationally alien, I have to expect that being alone in this sort of thing is going to be the norm, not the exception. Everything that I thought was good about me doesn’t seem to impress anyone. I have used up the time and money that I had to spare toward making a new start in life through this stupid School of Social Work, and it is amounting to nothing. Worse than nothing, if it produces a black mark on my record. It would have been better not even to try. This feeling is particularly bleak at its worst. I experienced that worst state only briefly, and that was several years ago. Today, it was probably only around 30%. But because it is such a terrible dragon, even 30% is pretty uncomfortable.
Anger. I probably would have admitted that I was angry on March 20 but, interestingly, I did not become clearly aware of this one until March 21. At that time, on March 21, I had the sensation of catching myself in a form of denial. I think the situation is that I long ago learned or concluded that anger was unacceptable, and have therefore built up a possibly imperfect cognitive control that reinterprets, channels, denies, or otherwise attempts to convert anger into other thoughts or emotions, or possibly into more intensity within those thoughts or emotions. When I do become aware of my anger, it generally tends to be late in the game, as if I am finally awakening and realizing that I have been wronged. For whatever reason, the belated awareness in this case is typical for me. I guess the reinterpreting/channeling mechanism must be working pretty well, because although anger may be one of the most fundamental of all of the emotional or thought-stimulating engines running in this race, it does not really seem very descriptive of my situation – certainly not as descriptive, anyway, as the other headings mentioned above. In practical terms, then, I guess my anger has probably been somewhere in the vicinity of 30%.
Detecting Automatic Thoughts
With those words, I completed my description of the experience. Now, what were its automatic thoughts? According to Kuehlwein, the “automatic” aspect means that the thoughts do not come “through conscious effort”; instead, they arise out of “deep, personal meaning-making structures” (p. 133). In lieu of extracting every last automatic thought from the foregoing pages, it seems appropriate to offer some examples that may capture much of the content under the various headings. Under the Suspicion heading, the most prominent automatic thought is along the lines of “I fear that the Provost is up to something.” Under Fear, there is an automatic thought that says something like, “The Provost is a lawyer, and lawyers are unfair, so the Provost will be unfair to me.” Under Humiliation, one automatic thought is, “I will feel ashamed as a result of the way in which they want to use their power.” Under Dismay, it is, “There is nothing I can do about their willingness to attack me unfairly.” Under Disgust, it is, “I am better than these social work phonies.” Under Distrust, it is, “I must remain aware of the threats posed by someone like Dr. Kreuger, whose genial veneer vanished pretty quickly on slight provocation.” Under Lack of Control, it is, “I cannot prevent the Provost from judging me without justification.” Under Flight/Refugee Status, it is, “My life is going to fall apart again.” Under Loneliness/Grief/Despair, it is, “I am always going to be alone in this sort of thing.” I did not identify specific thoughts under Anger, and am not sure there were any to identify, except as manifested or channeled into the foregoing categories. The challenge, with respect to these thoughts and others like them, is to decide whether they were, in Kuehlwein’s terminology, “adaptive” to the situation or, instead, “dysfunctional” (p. 133).
DTR Heading: Adaptive Response
What cognitive distortion(s) did you make? Define the cognitive distortion. The list (taken from class handouts): all-or-nothing thinking; catastrophizing; discounting the positive; emotional reasoning; global label; magnifying/minimizing; mental filter; mind reading; overgeneralization; personalization; “should” and “must” statements; tunnel vision.
(Note: the foregoing paragraphs describing thoughts and emotions were completed on March 20. But the foregoing paragraphs describing the process by which I analyzed these thoughts and emotions were written on March 21 and thereafter, after my meeting with the Provost, as were the following pages. In the following paragraphs, I have attempted to identify some but not necessarily all of the cognitive distortions that could conceivably have figured in the foregoing reactions.)
Suspicion. Mind-reading: I relied on flimsy evidence to interpret the Provost’s likely views. Discounting the positive: he was pretty agreeable and adaptable in his e-mail contacts; he did not seem like the type to be scheming with Drs. Kreuger or Watt; he does not appear to have any idea of what is going on over at the School of Social Work. Personalization: the man probably doesn’t give a hoot about me; he is probably just doing his bloody job.
Fear. Labeling: So what if he’s a lawyer? I’m a lawyer too. Not all lawyers are the same. If I’m not afraid of my own concept of fairness, why should I be afraid of his? Maybe he, too, would think Posner is dangerous. Mental filter: he got mad at me because I irritated him. It could really be my fault, just as he sees it. Emotional reasoning: the fact that I am afraid of him for getting mad at me and being a lawyer does not mean that he becomes an actual threat to me merely by dint of being a lawyer who got mad at me. Overgeneralization: not all judges are the same either. And I’m not actually sure that he got mad at me at all, though evidently some of my questions did tax his patience a tad.
Humiliation. Overgeneralization: Nobody except Drs. Watt and Kreuger has actually treated me like a convicted criminal, except for a few social work professors. Of course, people will not necessarily say things to your face; but you don’t do yourself any favors by making something out to be a bigger problem than it may really be. Classmates actually seem pretty supportive. Catastrophizing: As for “bowing down to arbitrary authority” – well, I suspect the University’s procedure would not stand up in a court of law, but you’ve got to be prepared for abuses of power in this country, and in the grand scheme of things this was a pretty minor one. It was just a conversation that had a few upsetting moments but turned out pretty much in my favor. I wasn’t ridiculed after all. All-or-nothing thinking: Dr. Watt didn’t achieve anything by this charade, other than to waste some of my time and upset me for a while. The behavior of responsible persons in the School of Social Work didn’t amount to much either. It has turned out to be more a matter of “shame on them” than of “shame on me,” and I think that is how others will see it too.
Dismay. The things that I wrote under this heading, coming later in the initial processing of my feelings, are harder to discredit. They are phrased somewhat less vehemently, and they express a point of view that I had already arrived at previously and which I characterized, last night, as having a 90% level of intensity. Probably the closest I could come to this, in the list of cognitive distortions, is mental filter: I was preoccupied with the common element of being placed in line for judgment when I did nothing wrong, and that single commonality triggered the feeling that I was going to be punished, that the punishment would be unfair, that nobody would give me an opportunity to request reconsideration or grant an appeal, and so forth – where, in this case, unlike the family scenario from several decades ago, there was not firm support for any of those other suppositions.
Disgust. Overgeneralization: These social work professors aren’t necessarily representative of social work professors in general, and social work professors aren’t necessarily representative of social workers in general. All-or-nothing thinking: The fact that no professors staunchly defend any of my rights in public opposition to other professors does not mean that no professors would defend my rights quietly, or that none have actually done so in discussions to which I am not privy, though there remains the problem that those defenders, if any, are willing to let met twist slowly in the wind. Labeling: Calling social workers (or even the social work professors in question) unprincipled may be an overstatement; they may firmly defend principles that matter to them. They need not defend every possible principle, in ways that I would prefer, in order to be fairly principled people.
(Having exercised my imagination to find evidence of multiple cognitive errors in the foregoing instances, I will proceed more summarily with the balance of my initial reactions.)
Distrust. Emotional reasoning: Because I feel betrayed or alone does not mean that I actually am.
Lack of Control. Catastrophizing: Plainly, my fears were far ahead of the reality. Nobody wrecked my world, and the Provost certainly did not come across as someone who was interested in doing anything of the sort.
Flight/Refugee Status. Most of the errors in this paragraph were already stated above. One that may be distinct has to do with the glimmer of extreme fears (e.g., being thrown out of the program, becoming homeless, dying), which again seems like catastrophizing.
Loneliness/Grief/Despair. The fears expressed in this paragraph were, again, a summation of how bad things might be if all of my worst fears, above, were true. Perhaps its chief characteristic is black-and-white thinking, in that the statement of worst-case possibilities overlooks the fact that, meanwhile, I am developing strengths, building credentials, accumulating experiences, and otherwise achieving some positive things as well as the negative, feared ones.
Use questions to compose a response to the automatic thought(s): What is the evidence the automatic thought is true? Not true? Is there an alternative explanation? What’s the worse that could happen? The best? What’s the effect of believing it? Of not believing it? What should I do about it? What would I tell _______ (a friend) if he or she were in the same situation? How much do you believe each response?
I think I have already responded to these questions, for the most part, in the foregoing discussion. It seems appropriate, however, to register some additional concerns and to explain what I think will happen next, if I pursue the cognitive approach in the present case.
In searching for signs of cognitive errors as just demonstrated, I became aware that many of the cognitive distortion labels boil down to the general premise that the client is simply inclined to overindulge the negative. The specific distortions are essentially attempts to identify different specific ways in which the negative gains the upper hand. The identifications (e.g., “overgeneralizing,” “catastrophizing”) are pejorative – that is, they seem designed to belittle the negativistic predilection. As such, they contain the possibility of belittling or dismissing the client’s valid concerns along with the invalid ones – and, in the process, of belittling the client him/herself, if I (as therapist) get too far out in front of where the client actually stands. I do the client a disservice if I approach his/her problem with the prejudicial belief that every client is making cognitive errors that I, with my superior intellect or training, can detect (or can help him/her detect) and remedy. Expressed differently, The Power of Positive Thinking [for example] is a worthy book, but it is not capable of saving the world singlehandedly.
My self-challenges, above, do not have the ring of gospel; rather, they are arguably valid points in an internal debate that continues over the years. If I am negatively inclined – or, better phrased, to the extent that I am negatively inclined – I can expect myself to have a retort to a number of the foregoing dismissals. My retorts may or may not be logically valid; further application of the list of cognitive distortions will presumably be needed to learn more about that. But even if logically invalid, they may arise to some extent out of my interpretation of my own experience, possibly flavored by depression or some other malady. To the extent that that is so, I would think that identification of cognitive distortion – the search, that is, for the difference between thoughts that are adaptive and those that are dysfunctional – might eventually have to address, not only the immediate circumstance (i.e., this March 20 experience of being upset about the Provost), but also the interpretation of past experience that inclined me to react as I did to that immediate experience. Otherwise, I may be unrealistically expecting the experience of a few weeks of therapy to override the accumulated (albeit distorted) interpretations of decades of previous experience.
Having expressed those concerns, I would say that, in general, I think I am probably the kind of client who has already incorporated elements of the DTR into my internal dialogue. I do not think such a client would stay with me [as therapist] if I approached the project rigidly, minimizing or overriding his/her existing capabilities (that is, his/her strengths) in the name of performing exactly the specified steps of the DTR in exactly the prescribed order.
The central task, as I understand it, is to train the client to challenge maladaptive thoughts by applying pejorative labels to various manifestations of an overly negative outlook. The facts that my self-questioning has brought The Power of Positive Thinking to mind, and that I have just cited that book in a nearly sarcastic way, suggest that I felt, at that point (i.e., a few moments ago), that the next task, in my case, may be to explore whether a negativistic tendency derives, not from mere cognitive error on the level of the particular incident (whether, for example, I was wrong in being suspicious in merely this one instance), but rather from some fondness for the negative, or some comfort or familiarity with it, on some less ephemeral level.
DTR Heading: Outcome
How much do you now believe each automatic thought? (0-100%) What emotion(s) do you now feel? How intense is the emotion? (0-100%) What will you do (or did do)?
It seemed beneficial, as I was going through this exercise, to juxtapose the stressful situation against the cognitive evaluation by writing the first section (pertaining to the stressful situation) on the day when I was experiencing that stress, and then writing the second section (containing the cognitive evaluation) on a day when I had already gotten past the meeting with the Provost and was no longer much concerned with it. I think that juxtaposition was indeed useful, for purposes of highlighting just how stark the contrast could be – how silly and overblown my fears could seem in retrospect.
I wish, though, that I could also have had the luxury of undertaking a cognitive examination of some such set of fears and putatively dysfunctional thoughts on the same day – critiquing them, that is, while the stress was still active. I think now that doing so might have been more effective in showing me what it is like to confront a maladaptive thought when that thought still holds sway over me – when it does not seem silly in hindsight. Doing so would also have presented a more realistic client situation; after all, clients are not going to be coming to me for help with problems that, to them, seem silly in retrospect.
Because of these factors of timing, I cannot say how much of the change in my viewpoint is due to the cognitive treatment, and how much is due to the mere dawning of a new day. Or, more accurately, I can say that I do not think the cognitive treatment accomplished much beyond giving me a general reminder of the possibility that I was being overly negative, along with a vocabulary of ways in which negativity can occur (e.g., catastrophizing).
But, like most people, I have been negative at times in the past. Also, probably like most people, there may be some regards in which I automatically gravitate toward a negative interpretation in the present. Or at least, one thinks, that would tend to be true of many clients. Why does negativity persist despite the availability of books like The Power of Positive Thinking? Indeed, why do such books become almost a joke among the habitually negative, or during people’s bouts of negativity?
I think part of the answer to that may come from the fact that, according to the [assigned reading], the DTR is designed to be used as part of ongoing homework, not just – as we are using it – as a one-time fix. [The reading] also specifies that the client must believe in the cognitive model, but says that this is important just so that the client will understand the importance of distinguishing thoughts from emotions; but the present case makes me ask whether the event-oriented use of the cognitive model can effectively access the roots of negativism. Finding an answer to that question may require a look at core beliefs, which I will undertake in the next section.
2. Upon completing the DTR form, summarize the information in a type-written narrative that could be presented as an assessment. Apply cognitive therapy concepts (e.g., the cognitive model, Socratic questioning, etc.) that you have learned in class. (Refer to lecture powerpoint slides, handouts, and readings.)
Kuehlwein (pp. 138-139) responds to the concern just mentioned by recommending that the client first have a complete DSM-oriented workup, as well as an assessment of historical background variables, and also that there be ongoing effort at symptom assessment through weekly administrations of e.g., the Beck Anxiety Inventory. In that view of the cognitive approach, the present lack of such information precludes the preparation of a comprehensive assessment here.
Armed with such information, and especially as therapy progresses, Kuehlwein contemplates a transition from event-driven applications of cognitive therapy, of the type undertaken here, to an investigation of “larger patterns and deeper beliefs (conditional assumptions and core beliefs)” (pp. 140-141). That seems to be exactly what the foregoing paragraphs call for in this case as well. It would perhaps not be too surprising if, to some irregular extent, a client with some tendency toward introspection or self-awareness (e.g., myself) may be inclined already to look beyond the single event, as examined in the DTR, toward larger patterns of some sort. Thus, while this document cannot draw upon the resources mentioned in the previous paragraph, at least it can undertake some questioning, in an attempt to grope toward some of the conclusions that such resources might have suggested. The preceding pages have already supplied some such conclusions.
The class handout on Socratic Questioning purports to describe such questioning in terms that are applicable to all disciplines. This opens the handout up to challenge. That is, I do not think it captures the essence of the Socratic method. (A few years ago, I wrote a plain-English restatement of Plato’s Republic (as evinced by a Google search for Woodcock and those terms) and, in the process, had the opportunity to become familiar with the Socratic method – which, of course, my professors had also used extensively, although sometimes in a harsh, non-Socratic fashion, in law school. I also had an opportunity to become somewhat exposed to Socrates as an undergraduate philosophy major and student of classical Greek.)
What is described in that handout is a general description of critical inquiry that is not uniquely Socratic. In a Google search for “Socratic Questioning,” I find that the Delta State webpage represented in that handout comes up second on the list, but I also find that a more accurate summary of the Socratic method arises a bit further down the list, on Piet Hut’s webpage, which quotes Aristotle as saying, “It was the practice of Socrates to ask questions but not to give answers, for he confessed that he did not know.”
Stated thus, an attitude of Socratic questioning could inject valuable humility into the therapist’s search to understand the client. Rather than assume that the DSM, the DTR, or some other tool can accurately pigeonhole the client, a Socratic approach recommends approaching the client in a frame of mind suitable to what Piet Hut calls “a true beginner,” regarding the question of what the client is really all about. While that attitude should underlie a good assessment, it does not provide substantive material at this stage of this assignment. It could, however, help to generate material in explorations (or even self-explorations) based upon the analysis provided here. Certainly I like to think that the analysis throughout this document has displayed traces of the more general approach to critical inquiry suggested in the “Socratic Questioning” handout.
Meanwhile, the “Cognitive Conceptualization Diagram” handout does have some important immediate uses. In line with Kuehlwein’s suggestions, above, it indicates that the inquiry begins with relevant historical data about childhood experiences that contributed to creation and maintenance of a dysfunctional core belief. Data of that sort, emerging from the foregoing description of my thoughts and emotions during the stressful period described in the first pages of this document, support the conclusion that the client here (namely, I, if I may slip into the third person for this part) may associate judgmental situations – that is, situations in which someone is critically examining his prior words or actions – with physically and emotionally brutal childhood experiences.
A relevant core belief appears to be that people who sit in judgment on the client are certain, or are at least uncomfortably likely, to bring personal or global biases to the task, or to have a preexisting agenda against which rationality and fairness will not prevail. On the conditional level, the client is able to ameliorate the resulting anxiety by reducing unknowns – that is, by increasing his sense of control over, or adjustment to, the biases or other undesirable realities of the judgment situation. His preoccupation with judicial processes, which is so strong as to inspire him to paraphrase an entire book by Judge Posner, may reflect an attempt to fortify himself with information about the varieties of ways in which that judge in particular, or judges in general, may commit logical errors or may otherwise be called into question.
In the present case, the client was anxious because the Provost – the person who, he anticipated, would be sitting in judgment on him – appeared to have become mildly iritated with him. This, by itself, may have been the catalyst for a nearly overwhelming cascade of what he calls “thought-emotion clusters” that were evidently hanging in the balance, waiting to be triggered by some major or minor event like this. Whether those clusters are always hanging out there or were, instead, erected in recent days or weeks, in response to the developing case involving Drs. Kreuger and Watt, is not yet clear. Either way, however, it would seem that this situation could have a deleterious impact upon the client’s life.
These thoughts pose the question of whether the client might find it less stressful to be called into judgment before a profoundly biased judge, than to enter a chamber where the judge’s position is unknown, because the latter might encourage hope that may then be cruelly dashed, in which case the client will be emotionally defenseless. If the bias were known to him in advance, he might be terrified; or he might make mental or experiential adjustments (e.g., obtaining reassurance from a friend that s/he, at least, knows that the judge is biased and that a negative outcome will not change his/her views of the client). This hypothesis does not jibe with his appraisal of Dr. Watt, who he did feel was predisposed against him and whose judgment he nevertheless avoided determinedly; but perhaps the resolution is that he reasonably tries to avoid situations of judgment to the maximum extent possible, and then erects defenses against anticipated judicial biases where escape is not an option.
The client’s efforts to gain control over situations of judgment, or to become adjusted to them, may yield some positive effects. He may, for example, have an above-average inclination to avoid or challenge judgmentalism or hypocrisy, given his apparent doubt that judging other people, or comparing oneself favorably against them, is a reliably valid process. On the negative side, on a practical level (as distinct from what ideal justice might dictate), he may counterproductively irritate the judge, as appears to have happened here, by striving to nail down details that the judge may consider trivial or may not be inclined to discuss in advance. In that sort of situation, the client’s fears may become self-fulfilling prophecies. Another negative consequence is that, in this case and probably in others, he spends these huge amounts of time agonizing over outcomes and possibilities, many of which are doubtless based on real experience and expressive of major concerns within his life – but which would perhaps not need to be addressed, at this time, if he were not quite so hung up on the impending situation of judgment.
The apparent fear of judgment sounds much like the example provided on pp. 156-157 of Beck’s book, where a client demonstrated all-or-nothing thinking in which the only options were superiority or failure. Here, the first glimmer of a negative judgment apparently evoked a slippery slope from which, to him, the certain outcome would be eventual and complete disaster. In these regards, the client displays feelings of being powerless, out of control, and otherwise unable to save himself from the inexorably destructive process of judgment. These terms evoke the “helpless” category of core beliefs that Beck (pp. 168-169) identifies.
These observations about judgment are not the only observations that arise from this case, but they seem to strike near, or on, many of his concerns, and might be an appropriate place to begin exploration. In light of the client’s “Second Set” of reactions, though, I am not confident that the identified fear of judgment constitutes the bedrock issue, or at least not the only one arising from the available information. The abusive childhood background, and his mention of “Lack of Control” and of a profound exposure to “Loneliness/Grief/Despair” a few years ago, combine to suggest that negative judgment itself is a concern partly (or maybe entirely) because it strikes upon something deeper, relating perhaps to abandonment or other rejection. Judgment could logically trigger that sort of concern – consisting, as it does, of a direct and potentially far-reaching official statement of exclusion of the person from some aspect of society.
That interpretation certainly meshes with the client’s apparent initial resentment of being treated like a “criminal.” It does not mesh so well, however, with his seeming resistance to “arbitrary authority”; one would think that a person so concerned with rejection would toe the line pretty precisely – would not dream of railing against authority. One possible explanation is that, perhaps linked to his fear of judges, he despairs of being able to satisfy authority. In any event, there is certainly enough material here to raise the question.
The underlying concept that distinguishes Beck’s category of “helpless” core beliefs from her other category of “unloveable” core beliefs seems to be that the former relates to proficiency within the workaday functioning in the world, while the latter evokes warmth, affection, and other positive emotions – or, rather, the lack thereof. Seen that way, Beck’s statement, “I am bound to be rejected,” from this “unloveable” category, sounds like a pretty direct summary of the client’s reactions to the prospect of being judged by the Provost. He does not seem to believe he is genuinely “bad” or “unworthy,” which are other terms from that same category, but it is possible that he would protest so vehemently against such findings precisely because he fears that he actually might be, and that a judge, in particular, is going to say so.
Otherwise, a number of his comments match terms from Beck’s “unloveable” category, including “uncared for” and “abandoned” (in his complaint about social work professors not standing up for principles that would help his cause), and “different” and “unlikeable” (in his concerns about being ridiculed or ganged-up on by some of his professors, and his list of reasons why he thinks some professors did not want to let him into the school in the first place, which include having “weird ideas,” being a lawyer and Euro male, etc.). Because of the intensity with which he describes these factors in his Second Set – and especially the ones pertaining to being “unwanted” and “alone” – I am inclined to think that his functioning within the world (that is, his status within the “helpless” category of core beliefs) is not ultimately as close to his heart as is his status within the “unloveable” category.
In short, the client’s automatic thoughts point to core beliefs of both the helplessness and unloveability varieties, where the latter are apparently preeminent. Again, without exhaustively cataloging all intermediate beliefs that the client’s various automatic thoughts may imply, it may be appropriate to identify one automatic thought and elicit its related intermediate belief by asking what it means to the client. A provocative one arises under the client’s Lack of Control heading, where the automatic thought he identified was, “The Provost wants to judge me without justification.”
There are several beliefs there, pertaining to the Provost and to the concept or experience of unjustified judgment; but the one that may be most directly related to the client’s sense of self-preservation is, “I cannot endure being judged without justification.” I see that this belief shares the grammatical format of items described, in my notes and in the texts, as automatic thoughts. In my way of coming at it here, it seems secondary to a perception about the Provost’s intent: that he does not merely want to judge the client, but that the client believes he is willing to do so without justification. But for purposes of the assignment, perhaps I should say that the automatic thought is the one stated in this paragraph. In that case, the intermediate belief – pointing to a core belief that the client is unworthy or eminently rejectable – is along the lines of, “When someone wants to judge me without justification, they are trying to accomplish a preconceived agenda, hostile to me, against which I have no possibility of defense.”
Socratic questioning could be useful to explore situations in daily life in which that belief is not borne out. Also, given the client’s relative awareness of his cognitive distortions, role-play (including rational-emotive role-play) might be an appropriate tool with which to bring home to him the maladaptive nature of his intermediate beliefs, and also to explore their origins. It could also be quite useful to use others as reference points – asking him, essentially, how it is that other people do not seem to share his reactions to situations of judgment. Perhaps the most useful tool, for dealing with the issue of unloveability, would be to encourage him to engage in “as-if” behavior, so as to defeat the possibility of a vicious circle in which he haplessly behaves in a more rejectable (or perhaps judgeable) way because of his fears of being rejected or judged. There may also be some possibility for behavioral experiments in which the client exposes himself to judgmental situations of various degrees of manageability, instead of running from them.
3. Complete a coping card that is based on your discussion of the adaptive response.
Automatic thought: “I cannot endure being judged without justification.”
Adaptive response: It’s not the judging I mind. That’s just like taking an exam. It can actually feel pretty good if I come out smelling like a rose – if, say, the judge decides in my favor and says positive things about me. What I mind is not being judged; it is being threatened. But I have been wrong about some such situations – thinking that a person sitting in judgment was out to get me when they really weren’t. My bigger enemy is the self-fulfilling prophecy – being so worried that I act weird or irritate the person. Instead, I need to focus on putting my best foot forward. I can do a pretty good job of that when I try. There will still be unfair judges, but I have survived them all. I have also learned valuable things from being exposed to them – wanting, for example, to be less judgmental myself. Also, if I handle my side of the judging situation honorably, I have a better chance of earning more sympathetic treatment when I appeal to some higher person or seek assistance in reducing the pain that the unfair judge inflicts.