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Giving in to, or appeasing, the voices: Submitting to voice commands, passively believing statements by voices, etc. Fight or flight: arguing with voices.

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Presentation on theme: "Giving in to, or appeasing, the voices: Submitting to voice commands, passively believing statements by voices, etc. Fight or flight: arguing with voices."— Presentation transcript:

1 Giving in to, or appeasing, the voices: Submitting to voice commands, passively believing statements by voices, etc. Fight or flight: arguing with voices or running from them, such as through distraction Mindfulness: being aware of the voices but not feeling compelled to believe or act any particular way because of them.

2 Picture world as good and positive, to comfort self and feel relaxed. Picture world as dangerous, so that one won’t be overwhelmed by any risks that weren’t anticipated Notice dangers that are prominent but also possible areas of safety. Try to picture world accurately in regards to safety versus danger.

3 Block out the trauma or distress… it just doesn’t exist…numb. The trauma or stress intrudes into everything: it seems to be happening right now and is overwhelming The trauma or stress is accepted as part of the story: but the story is still ongoing and is free to move in positive directions

4 I think or feel it: – therefore it is true, even if everyone else says it isn’t. My thoughts and feelings are unreliable: and others offer so many different opinions – there is no way to decide what is true. I can check in with myself and with others, and make a conclusion based on what I notice: If I find later there is a problem with my decision, I will change my mind.

5 Try Too Hard: If something is worthwhile, I must keep working towards it no matter how much I suffer. Not Try: Working towards things leads to disaster and impossible stress, so it’s better to give up before I start. I can work toward things and see what happens; If the stress is too much, I can let go, at least for awhile, then I can resume where I left off.

6 I define myself completely independently of others. If I say I am captain of a spaceship, then I am. I am mentally ill or incompetent, I cannot define myself. Others tell me who and how I am. I negotiate my identity with others. My identity emerges out of the mix of what I propose and what I do, and how others see what I propose and what I do.

7 I define myself completely independently of others: I am invulnerable. I am completely vulnerable to how others see and define me: Often I can’t stand to be looked at because of what might happen to me. I negotiate my identity with others: In general I care how others see me but I am not a captive of the perspective of others. I decide what to make of how they see me.

8 Consumer: I think or feel it, therefore it is correct. Mental Health system: This person is wrong and mentally ill, therefore we must take control away from her and decide for her. Cognitive approach: let’s share some perspectives on where the distress here may be coming from & how to resolve it. Each of us may be making some mistakes ……

9 Totally focused on autonomy: self defining, others have no input or connection. I am what I say I am. Totally focused on belonging: has no self definition, completely defined by others. Some mix of autonomy and a sense of belonging: sometimes self asserting, other times relaxes and lets others define self. Comfortable intimacy with coexisting sense of independence.

10 I don’t need any medication: I dumped it all out this morning. Based on your diagnosis, you need to stay on medication the rest of your life, despite the side effects & risk of early death. Medication decisions should be thoughtful, & should consider possible benefits, risks, & the possibility for reducing need for medication over time by learning new beliefs & behaviors.

11 My beliefs are 100% true and I refuse to question them at all. I always “know” what is true. I question all beliefs, even what most people take for granted. It’s hard for me to “know” or focus on anything, because I am so uncertain. I hold beliefs tentatively. I’m open to questioning my beliefs, but I do so gently to avoid overwhelming my ability to stay organized.

12 Dysfunctional Thought Control Strategies: I must control everything that happens in my mind. Of course I can’t control this, it’s not me doing it: these thoughts, images, & impulses are coming from the CIA or….. I am vast, I contain contradictions (as Walt Whitman said). I don’t need to control everything in my mind, it’s only my actions that I need to focus on.

13 Overly valuing spontaneity: Whatever thoughts or impulses come into me are true and correct Fearing and resisting spontaneity: My thoughts and impulses get me into trouble, I am “ill” and must strive to be normal at all costs Valuing spontaneity but also sifting through it: my spontaneous thoughts and impulses are part of me, but only some of them fit each situation

14 Too much creativity: I can see innumerable ways of interpreting the simplest statement….. Too little creativity: To avoid getting caught up in chaos, I must choose one fixed interpretation and stick with it no matter what. I can walk the edge between order and chaos, I can consider a few possible meanings and see how they fit the context, and if necessary explore even further…..

15 Too much creativity: I try to win my way back to social acceptability by convincing others of the value of my bizarre experiences and interpretations Too little creativity: In attempting to avoid being judged for being bizarre, I end up being too flat, “negative symptoms.” I can hold on to, or let go of, my creativity as appropriate, I can find something of value in my uniqueness to share with others, while also letting go of it when it doesn’t work.

16 I believe something is fundamentally wrong with me: this leads to negative emotions and over-reactions in an attempt to correct things, which often compounds problems. I don’t see any problems with myself or my views: This means my mistakes don’t get corrected, instead they get compounded & escalate till I’m in serious trouble. I see myself as fundamentally OK, but am open to learning about where I might be wrong: I usually catch mistakes before they get huge.

17 Comfort self by assuming a very narrow identity: I am only what is good and under control, that other nasty stuff is not me. Seek peace by allowing everything in: I won’t perpetuate internal conflict by trying to reject any thoughts, feelings or impulses as inappropriate Accept things as belonging somewhere, but wrestle to put them into perspective; everything I experience is part of me, but I continually sort out what is most helpful in a given moment

18 No rationality or comparisons: A thought, perception, or experience is just taken as perfect in itself, without comparisons or rational criticism. Too many comparisons or too much rationality: No ability to decide, relax, or enjoy, because endless comparisons, endless second guessing, etc. Coexistence of some rational thinking with irrational spontaneity: Can compare things rationally but also has enough of the spark of imbalance to cut off comparison & move forward.

19 Experiential Avoidance: Attempts are made to not have thoughts, emotions, impulses, perceptions etc. which are evaluated as “bad.” Emotional reasoning or fusion: Emotions and other mental content is just taken as true in itself, and allowed to determine the person’s direction, without rational criticism. Some ability to practice mindfulness; Willingness to experience whatever is in one’s mind, but also able to disengage from it and see other perspectives.

20 I must go to an extreme to be safe and/or correct: Life is extreme and demanding, and I must be extreme in response. I must always be moderate: Being extreme in any way is a sign of sickness, I must always be in the middle, always be normal. All things in moderation, including moderation: It is normal to be extreme at times, though I can also be comfortable in the middle; I have options.

21 Totally Spontaneous: I think or do whatever occurs to me, with no pause for self- criticism. I jump to conclusions. Overwhelmed by self- criticism: I see flaws in everything I come up with, nothing is good enough. I stuff any feeling that might lead toward a conclusion. Spontaneity mixed with modest editing or self-criticism: I value my spontaneity but I can also step back from it and can often sort out the useful from the not.

22 Inability to calm self, to stop worrying or decide on a path: Nothing is good enough, I must continue to fret endlessly. Complete certainty and being unperturbed no matter what: I am completely happy with my thoughts and interpretations even when they are out of touch. Willing to question myself but also able to decide when I have questioned or fretted enough: After what seems like enough worrying or fretting, I decide what to do and just do my best.

23 Very attached to outcome, attempting to control, caring to the point of being overwhelmed: I can’t let go even if it’s unnecessary and/or it’s killing me. Very detached, not attempting to control, not caring to the point of self neglect: I deal with potential frustration by not trying. Detached from the irrelevant, Attached to living out core values: I do my best to act on my values and once I’ve done my best, I let go of the rest.

24 Too many associations: I see so many possible associations, so many meanings, that nothing makes any particular kind of sense. Too few associations: I see only one or two fairly dull ways of looking at things. Excessive focus, things have meaning but it is narrow and sterile. A balance between focus and ability to make novel associations: I can focus in conventional ways, but also break free at times to see new forms of meaning.

25 Depersonalized - experience oneself as totally separate from body and feelings : Fused with body reactions and feelings: I can’t do or think anything independently or in opposition to them. I have my feelings and body reactions, but I am also more than that:

26 Overprotection from criticism : No criticism is accepted, even that which could be very useful. Overly defensive. Collapse under criticism: Cannot sustain own point of view, gives too much weight to critical views. Open to hearing criticism but makes own decisions about what to make of it: Can often see criticism as partly true, partly not, and use it constructively.

27 Low arousal : Not thinking about it, dull, passive, not making distinctions or seeing differences. High arousal: Black and white thinking, extreme reactions, highly polarized Medium arousal: Making distinctions and applying values, but also seeing commonalities and shades of grey. Can make an effort and then let go.

28 Thinking that perpetuates stress : Person is unwilling to see any problem as too difficult to solve, no letting go of problems even as person becomes overwhelmed. Letting go of too much: Person does not face or address problems or even bother to think logically about them. “…accept the things I cannot change...courage to change the things I can…” Person can do rational problem solving but also “let go” of problems when they are hopeless or overwhelming

29 Fixed associations based on trauma : For example, my abuser wore a green coat, now all green coats mean severe threat Dissociation to protect from trauma associations: I avoid traumatic over-reactions by under- reacting, but then I fail to protect myself from future threats…. I can think through whether associations with the trauma are relevant or irrelevant in a given situation. Balance between associate and dissociate.

30 Conscious mind seen as one’s complete identity and all powerful even though it is just a fragment of the whole. Conscious mind feels demoralized and powerless. Conscious mind comfortably shares power with that which is less conscious at any given time.

31 Acts only on consciously approved feelings and avoids, blocks out, or dissociates others : Unstable or excessively narrow identity. Acts on whatever feelings emerge in the moment: Fuses with and acts on feelings that are not subject to conscious evaluation. Open to input from all feelings but integrates the feelings into an overall sense of values before acting: Influenced by feelings but not overwhelmed by them.

32 There is no problem: If anyone thinks I have a problem, that is a problem with them. I am and will continue to be the problem, I’m mentally ill: I hope someone gives me a pill to change me into something not quite so bad. There is a problem, but it doesn’t define me, and it’s potentially temporary: I will pay attention, learn about it, get help, and try different things, and the problem can likely be resolved.

33 Numbing: None of this matters to me, I’m indifferent. Hyperarousal: Every detail is critically important, I must be totally on guard. Relaxed awareness: There are real issues here for me, but I can deal with them in a relaxed and coherent way.

34 I am weak, others are bad and dangerous: I need to watch out for them, but there isn’t much I can do. I fight others, they see me as dangerous and bad: I’m defending myself in the only way I know how. I have some power and stick up for myself successfully: Because I assert myself, others aren’t so bad to me and they don’t see me as bad either.

35 Excessive aggression toward self: I see myself as deeply flawed, worthless, unsafe, guilty, shameful, etc. All my negative emotions and voices are correct. Excessive defending of oneself: I see all critiques of myself as invalid, and so I block the emotion or voice, or see it as totally external and evil. Self affirmation combined with reasonable openness to self criticism: Critical emotions or voices or thoughts are often partly wrong yet partly right: after all I am simply human.

36 I surrender to a higher power, or voice, even when it appears to be persecutory or corrupt: Since I have no real power, I might as well surrender now and get it over with. I never surrender to a higher power, or let go in any way: I take responsibility for everything, even the impossible. I refuse to ever lower my expectations. I do what I can, then I make wise choices about when and how to surrender or let go of the rest: I turn over power only to what is good or once I have done what I can to create what is good.

37 Fear of going mad: Hypervigilant for signs of madness, attempts to control thoughts and emotions, reacts strongly to minor anomalies. “Sealing over,” don’t even think about possible madness: If I don’t think about madness then I won’t be bothered by it. It’s normal to be a little crazy, but I can catch things before they get out of hand: Not stressed by minor anomalies, but does effectively challenge dysfunctional reactions.

38 Excessively metaphorical thinking: Everything is connected, and everything is everything else; I’m dreaming while awake. “Wave” Excessively literal thinking: I fail to see connections and similarities, for me the world is divided into categories that have nothing to do with each other. “Particle” Mix of literal and metaphorical thinking: I can both see distinctions, and see similarities that go beyond the distinctions. “Particle and Wave”

39 Remember so vividly it seems to be happening right now: The memory is so vivid I get retraumatized just by having it, and I still don’t put it in context. Refuse to let the memory intrude: I stop the memory from retraumatizing me right now, but I also fail to integrate it so I will run into problems with it later. I let the memory occur, but I have ways of reducing its intensity: I can note that reduced intensity and remind myself it is just a memory now.

40 Cutoff: I’m not connected at all to my ….. Family Feelings Thoughts or voices Etc. Enmeshment: I am totally defined by, and I’m drowning in, my …. Family Feelings Thoughts or voices Etc Individuated: I am connected to, but I am not defined exclusively by, my …. Family Feelings Thoughts or voices Etc.

41 Too intentional, too focused on control: I try to control my thoughts and everything that goes on inside me, I can’t even let go in order to sleep. Too spontaneous: My conscious mind is too passive, associations are made in a dreamlike way, there is no order. Good mix of spontaneity with self control: I can focus on important intentions and self control, but I can also let go in various ways, to laugh, sleep, etc.

42 Over-valued experience: I see my experience as completely true and significant. Overly concerned with controlling the experience: I believe having the experience can destroy me so I focus on trying to get rid of it. Willing to have the experience but put it in perspective: I don’t need to stop myself from having the experience, but I can put it into perspective & not make too much of it.

43 I am my thoughts or experiences: I must control my thoughts and experiences so that none of them are evil or crazy. These thoughts or experiences are coming from somewhere outside of me: I’m not responsible, I’m the victim of others. I own my thoughts and experiences, though they don’t define me: It’s what I choose to do with my thoughts and experiences that makes me who I am.

44 I am completely self- determining: I withdraw from anything that I cannot control. Only that which I decide is part of me. I am completely vulnerable: I can’t change anything, I have no responsibility. I’m a victim. I am both self- determining and vulnerable: I choose my initiatives and responses, but I am also vulnerable to others and to how what I initiate is received, both internally and externally.

45 Distrust any feeling of safety: Remember times in the past when safety proved to be an illusion. Be on guard! Distrust any fear or feeling of threat: Remember how I gave in to false alarms in the past. Suppress the fear, full speed ahead! Be open minded about safety and danger: I accept the reality of uncertainty, I question both fears and feelings of safety, I make as wise decisions as I can and then correct course when I detect a mistake.

46 I desperately need you: Without you I am nothing. I don’t need you at all: Nothing you say, think, or feel means anything to me. I am just so independent! I prefer to connect with you, but I make do, or find others, if you aren’t there: You mean something to me but I am something without you as well.

47 I put everything into airtight categories or compartments: Everything is completely separate and has nothing to do with anything else. It’s very orderly. I see the world without any categories at all: I have no way to organize my perceptions or make any sense out of them. I see everything as different in some sense yet also the same in some sense: I’m willing to explore different senses, different ways of organizing information or not.

48 Positive Symptoms: Mind is over- reactive in response to stress and lack of control, jumps to conclusions, etc. Negative Symptoms: Mind protects itself by under- reacting to stress or lack of control, by not trying etc. Balance between under and over- reacting: If I’m off balance one way or the other, I quickly self correct. I try but not too hard.

49 I am dominant: I don’t trust others or what they have to say. I decide what will happen, when, and how, without input from others. I am submissive: I can’t trust myself, and others have all the power; I will only get hurt if I oppose them. I have something to say, but I also accept input from others: I listen to different viewpoints, then I do some mix of going along with others and deciding my own path, depending on the situation.

50 I am always focused on being adjusted to things as they are. I can’t change things so I just accept them as they are, even when they are rotten. I am always maladjusted: I totally resist things as they are, even when fighting against them leads to my self destruction and no real change in what I don’t like. I am creatively maladjusted: I can roll with things as they are when that makes sense, but I can also pick a good time to make a stand and work for meaningful change.

51 Creativity without Spirituality: Metaphor is taken as real, rather than as pointing at something else beyond it. Spirituality without Creativity: Seeing no metaphor for experience, no way to express it or put it into words or images, it is overwhelming. Healthy dialogue between spirituality and creativity: I can come up with metaphors, images and words for things, but also recognize that reality goes beyond those containers.

52 What is going on in my mind is what is real. I don’t need to look outside of my mind or question it in any way, if my mind says it’s real, it’s the literal truth. What’s going on in my mind has nothing to do with reality: The contents of my mind are all crazy, and I am helpless to engage with the world in any meaningful way. What’s going on in my mind partly represents reality and partly doesn’t: I engage in an ongoing meaningful interaction where I test out ideas and clarify what’s in my mind.

53 Excess focus on conflict: I am always ready to do battle with the voices, my goal is to drive them out of existence. Excess focus on appeasement: It’s better to give in to the voices, even when they are unreasonable, rather than risk upsetting them. Focus on living a good life: I don’t waste energy opposing the voices just for the sake of conflict, but if they push for something that will harm my life, I will stand firm against it.

54 Fight or flight: I take extreme action to avoid or defend against what threatens me. Freeze or submit: I take no action to avoid, or completely give in to, that which threatens me. This protects me from damage that could be caused by attempts to fight or flee. I see a spectrum of choices: I can pick whatever seems like the most appropriate behavior, including options in the middle ground between fight/submit and flight/freeze.

55 Overly risky behavior: I avoid noticing risks that are present, so I can feel free to move ahead in my life no matter what. Excess risk avoidance, or too many “safety behaviors”: I avoid danger even when risks are low compared to potential benefits, and this stops me from moving forward in my life. Wise choices about what kinds of risks to take: I am thoughtful regarding which risks are best avoided and which risks it makes sense to take so I can move forward.

56 Avoid worry and see it as a threat: Worry is dangerous to me. I need to distract myself so I don’t worry, I can’t control my worry if it starts. Overly values worry: Worry is necessary to protect me from having bad things happen to me. Can worry to a realistic degree, then drop it: I need to worry enough to come up with a reasonable plan, then I can just proceed with the plan and see how things work out.

57 Hate abuser and reminders of abuser: I want to eliminate even a trace of the memory of the abuser from my life, so I don’t have to feel victimized anymore. Felt need to remember the abuser & the abuser’s perspective in order to defend against it: In order to be safe, I must remember the abuser & his perspective. I can put the abuser into perspective rather than see myself through his/her perspective: I’m not scared of reminders of the abuser because they are no longer a big deal to me.

58 I need to calm and soothe myself no matter what: If I fall apart inside, I will be completely useless, so I need to lie to myself about external threats if necessary to calm myself. I need to face the demands of the external threat no matter what effect that has on my internal world: I can’t take time to attempt any self soothing. I can face external threats while also managing to avoid over- stressing myself: I focus on doing what I can & then avoid over- stressing by letting the rest go.

59 I don’t want to understand myself or my past experience: Please distract me from myself, or numb me out, no matter what the cost! I am willing to face anything about myself, even that which I’m not ready to handle: I don’t have any sense of preparedness or pacing, so I overwhelm myself. I get to know myself gradually: I make sure I have resources to fall back on so that I can handle difficult experiences as it comes time to face them.

60 Reacting to my unique self, and my unique traumas and unusual experiences, I seem weird to others: But I just act on what I feel, even if the social consequences are not good. I see a need to hide my weirdness from others: This means that instead of trying to express myself with others, I am more focused on hiding myself, which makes me weird. I honor my uniqueness but also explore what I have in common with others: I can follow social norms when that makes sense, but I also get around to expressing what is different about me.

61 I’m spiritually fine, perfect just as I am: I don’t need to do a thing to make anything better, I’m invulnerable, perfect, beyond criticism. I’m evil and doomed: I’m in hell already, persecuted endlessly, full of evil, there is no way out. I have lots of faults but that’s understandable: I move toward what I see as good as best I can, changing course as I learn more, and this process of doing what I can is perfectly acceptable.

62 Identify with the status quo before the trauma: Everything would be OK if I could just go back to that. Identify with the new viewpoint developed in response to the trauma: Everything will be better if the new beliefs and perspectives just win completely and blow the old patterns away. Improved perspective evolves out of the tension between previous viewpoints and those resulting from the trauma: I value all my experience though I need to wrestle to find the right perspective on it.

63 Identify with the status quo before the psychosis: Everything would be OK if I could just go back to that. Identify with the psychosis: Everything will be better if the new beliefs and perspectives just win completely and blow the old patterns away. Improved perspective evolves out of the tension between previous viewpoints and the psychosis: I value all my experience though I need to wrestle to find the right perspective on it.

64 I am what I am identified as: Whatever I am currently doing and however I am seen, that is who I am. I am not what I have been identified as: Whatever I am currently doing or being seen as, has no relationship to who I am. My identity is always emerging: I am not just what I have already done or how I have already been seen, rather, I am also the process of recreating myself to meet each new circumstance.

65 I need to escape from or destroy whoever hurts me: I need to withdraw from or destroy those who hurt me no matter what. I need to attach even when it hurts: I can’t afford to be alone, so I need to accept any pain as being my own fault and see the other as blameless. I can learn to escape from or cause change in the “dark side” of others, while maintaining positive connections: I experiment with trying to change myself, my relationships and others to make this happen.

66 I love everything and everyone absolutely: Everyone and everything is perfect just the way it is, so I have no right to alter or hurt anything, even if my needs are unmet. I want to destroy all of creation: I am unhappy, so everything and everyone must go, or be obliterated. I balance respecting and enjoying things as they are with taking action to meet my needs: A good balance can emerge from the tension between the appreciation of things as they are, and the need to move and change.

67 Overly focused on control: I must control my own thoughts and feelings, and also control what others secretly think and feel about me. Giving up control: I can’t control anything so why try. I make a reasonable attempt at control, then let the rest go: I try to create a good impression, but I accept that I am always only partly in control of what actually happens.

68 Self esteem no matter what: I am determined to think positive about myself no matter what. I block out information that doesn’t fit my positive thoughts. Self criticism without restraint: I am determined to see all my faults, even those that are imaginary. Self esteem that incorporates reasonable self criticism: I am open to realistically seeing both my strengths and weaknesses, and my self esteem is based on seeing myself relatively clearly.

69 Ignore context, I know what things are: I will go ahead based on my current perceptions without paying any attention to wider context or contrary evidence. Context changes everything, nothing can be trusted to be as it seems: I must be hypervigilant for the subtlest indicators that may show that everything is different. I try to use good judgment: I proceed with my best judgment, but then if I see substantial evidence that I might have misjudged, I reevaluate.

70 I am innocent, alone, and helpless: Others harm me when they want, for no good reason, and there is nothing I can do about it. I am bad, but also very powerful and allied with powerful others: I choose to harm myself, or I choose to let others harm me, because it is the punishment I deserve. It will make me better. I am imperfect and vulnerable, but I do have some value and power: I experiment in looking for ways to escape mistreatment, either by changing myself or changing relationships.

71 Overly vulnerable after trauma: I cannot rely on anything to keep me safe. Previous knowledge has been shown to be inadequate. Overly reliant on denial after trauma: Through my new spiritual/magical method, I can now be invulnerable to the kinds of threat that happened before. Uncertain yet finding spiritual safety in uncertainty: I cannot rely on any “thing” to keep me safe. But I can trust the process of doing my best, then letting go in each moment.

72 Let go of everything Stress out endlessly Work, then relax

73 Magical thinking: I can solve any problem just by imagining a solution, I don’t need to be practical. All my problems are real: I am weighed down by how overwhelming it all is. Balance of realism and magic: I start solving my problems with imagination (which is enough in itself for the imaginary problems!) but then I follow up with practical action.

74 I’m bad, important others are good: I can bond with these others even though they hurt me (I deserve it for being bad.) I’m good, important others are bad: I must get away from them, or defeat them. I’m human and imperfect, and the others are as well: When we have conflict, I assume I will be right some of the time, and they will be right some of the time.

75 “Bad me” paranoia: I anticipate others will persecute me because of my badness. “Good me” paranoia: Since others are not so good, I expect they will persecute me. I’m a mix of good and bad, and others are as well: We will probably hurt each other sometimes, but not all the time.

76 Flashback defines who/where I am in the present Flashback is shut out: It has no reality at all Flashback defines a portion of the past, but doesn’t dominate the present

77 Persist in behavior with short term payoff despite reasonably clear evidence it will lead to a huge long term problem: Persist in strategy with a hoped for long term payoff, despite intense short term costs and the absence of clear evidence that long term payoff will come true Good balance of short and long term strategies:

78 Be flexible to fit immediate context: Even when this means giving up on longer term strategies. Have faith to persist despite what is believed to be a temporary lack of confirmation from immediate context: Even when costs are great and current feedback indicates strategy won’t work. Good judgment about when to be flexible and when to be unbending: I make good decisions about when to hold to my faith and when to change my ideas to fit new circumstances.

79 Fail to use “magic” or imagination even in areas where it best applies: Because of this, one is a victim of what has been imagined by others or other parts of self. Think “magic” or imagination, can be applied as a solution in an area where some other kind of action is needed: Believes in solutions that don’t work, and doesn’t do what would work. Uses magic or imagination when needed to experiment with reshaping how things are seen, but also takes practical action when that is called for.

80 Protect self from failing to perceive a threat by being biased toward seeing it: I’m not afraid to look on the dark side, but sometimes I see threats that aren’t real. Use “magic” or imagination or biased perception to increase sense of safety: I know how to look on the bright side! But I fail to detect many real threats. Constantly evolving and complex perception of a mix of threat and safety: I can often find safety in the midst of danger, and see the danger in assuming too much safety.

81 Destroying people’s autonomy in order to “save” them: Prior bad decisions are seen as proof that person’s autonomy must be restricted in the future by medications and other means. Just letting people destroy themselves: A person’s autonomy is respected, even to the point of letting them carry out bad decisions that destroy themselves and hurt others. Opposing bad decisions but supporting autonomy: Coercion used only as a last resort to block really major bad decisions: emphasis is on helping person regain autonomy combined with competent decisions.

82 Too great of positive expectations or the wrong expectations: Unrealistic expectations lead to frustration and suffering. Too few positive expectations: Important opportunities are missed because there is no expectation that they are available. Expectations fit the circumstances: Person learns to expect what is available & adjusts expectations to changing circumstances.

83 Too much attachment: I need things to be a certain way, I don’t let go even when hanging on leads to overwhelming stress. Too little attachment: I don’t care if there are losses and wounds, in fact I prove it by inflicting them on myself! Balance of attachment and detachment: I can value things and people and attach to them, but I can also let go when hanging on leads to too much stress.

84 Excess thinking in categories: I see things just in terms of pre- fabricated categories (seeing things excessively in terms of categories, and not specifics, is associated with depression.) Things are excessively specific: I see things only as individual events, as I result my senses are overloaded by the “blooming buzzing confusion” Balance of use of categories and ability to see how individual events or people don’t totally fit the category: Categorical enough to not be overwhelmed, but also able to get free of categories when that is helpful.

85 Excessively centered: Always stays close to the center in an attempt to retain flexibility, but in so doing loses the capacity to go to extremes, in other words, loses flexibility. Goes to extremes and gets stuck there: Expresses freedom from the tyranny of the center by going to an extreme, but then loses flexibility by being extreme. Balance of going out to extremes and coming back to center to regain flexibility: Looks like healthy attachment, where child balances exploring with going back to parent for comforting & nurturing.

86 Grabbing at straws to “see” a way of controlling an out of control situation: Often sees illusory patterns because looking so hard at faint associations. Giving up attempts to control, being hopeless: Person may give up even though some pattern of acting would have worked to control the situation. Balances need to maintain hope by noticing all possibilities for control, with need to “weed out” illusory pattern perception that could lead to misguided efforts.

87 Too little toleration of uncertainty: This leads to jumping to conclusions, to reduce the uncertainty. Too much toleration of uncertainty: This leads to being incurious, lack of interest, a negative symptom. Dynamic tension between acceptance of uncertainty and efforts to resolve it: This leads to a nuanced view, which includes both ability to make conclusions and an ability to see past conclusions.

88 A need or value is denied: This may reduce conflict with other needs, but perhaps out of awareness, pressure to meet the denied need builds up. Denied need or value suddenly becomes dominant: A long pent-up demand may be satisfied, but perhaps at enormous cost to other needs and values Needs and Values are integrated: Each need or value finds some kind of place, in a dynamic, shifting balance. Nothing is either totally denied or totally dominant.

89 My experience is meaningless, it is just the result of an illness: It is just the result of a chemical imbalance, or random misfiring due to a brain disease My experience is completely meaningful and accurate: All my conclusions are completely true and I don’t have to doubt or sort through any of them. My experiences have some value and potential meaning, but I may need to sort out in just what sense: I don’t need to reject any of my experiences but I may have to search to find a wise interpretation of them.

90 Psychotic experience is seen as entirely sick or bad: To be healthy I must seek to get rid of every bit of this kind of experience & of whatever is causing it. Psychotic experience is seen as very good: Efforts are made to have more of it & encourage whatever is causing it. Psychotic experience is seen as having a mix of danger and possible value: Health is seen as coming from sorting out the misleading aspects of the experience from potentially helpful aspects.

91 Divergent Thinking: Also seen as loose associations or even dissociation, leads to unusual perceptions & experiences, common in poets, visual artists. Convergent Thinking: Also seen as a narrowing of associations, fewer unusual experiences but also something like “negative symptoms,” common in mathematicians, engineers etc. Balance of Divergent and Convergent Thinking: Person can alternate between both thinking styles in a way that integrates into a good life.

92 Live in one’s own world: Be so unique in the way one sees things and expresses about things that others cannot connect, there is no communication. Fail to even have one’s own world: Be so focused on being “normal” that one has nothing of one’s own to contribute, nothing to say. Having one’s own world but also relating that world to the world of others: One is able to focus on the points of contact between one’s own world and the world as seen by others, so communication happens.

93 Being too closed off from others and from the world: What I hold as true is not affected by exterior evidence or by what others think. Being too sensitive to the world and others: What I hold as true can be easily overwhelmed by the views of others or by random bits of the external world. I have a semi- permeable boundary with others and the world: I use judgment to decide when to hold onto my views despite disagreement, and when to change them. I am just somewhat open.

94 Assume too much: I refuse to question my assumptions, my perceptions, and my conclusions. Assume too little: I question too much, don’t know what to assume, can’t organize my perceptions or make conclusions. I make assumptions: but also can open them up to questioning when they aren’t working out well.

95 Mistrust in the spontaneous, or Nature, or Spirit: Because I lack trust, I must rely exclusively on my own efforts, and so I get overwhelmed. Blind trust in the spontaneous, or Nature, or Spirit: Since I am so trusting, I make no efforts to sort things out for myself, or to question what pops into my head. I trust in my own efforts working alongside the spontaneous, or Nature, or Spirit: My own efforts have a role, but I don’t get overwhelmed because I can also let go and trust.

96 Overly focused on left brain processing: only that which is in words and/or makes logical sense is real… Overly focused on right brain processing: Patterns are seen in ways not easily put into words or communicated, and no attempts are made to logically sort things out. Both methods of processing are used: The gifts and the limits of each method of processing are noticed and respected.

97 Micro- managing mental events: I feel the need to control every aspect of how I think, feel, and process perceptions: it’s overwhelming! Lack of management of mental events: I give up trying to manage how my mind works, it’s out of control. Whatever I think, feel, perceive just is what it is. I don’t notice mistakes…… Balance of spontaneity with management: I trust my mind but also I’m aware it can make mistakes, and I have a process of detecting and working through them where possible.

98 Excessively internal locus of control: I’m not being abused or abandoned, it’s only that I’ve been bad, as soon as I change that everything will be better. Excessively external locus of control: I’m actually quite good, but various external forces (other people, voices, or entities) are evil and are persecuting me. Realistic locus of control: Sometimes I run into trouble because others are hostile, sometimes I create my own problems. I can learn to respond appropriately to each situation. Who’s responsible for what hurts? Abused children usually blame themselves, but as adults, may shift to blaming others excessively….

99 Focus on defending against external threat, guard against feeling too safe internally: to maintain vigilance. Focus on maintaining internal sense of safety, guard against perceiving too much external threat: to maintain stability. Guard against either ignoring threats or seeing exaggerated threat: I seek to be vigilant but not hypervigilant, to maintain a feeling of safety without being oblivious. Two Extremes in Seeking Safety, Not Very Compatible……

100 Therapy by formula: I just do what is in the therapy manual, whether it works or makes sense to the individual client or not. I always know exactly what I am doing though. Columbus therapy: I set off not knowing where I am going, get there & don’t know where I am, then get back and don’t know where I’ve been. Follows charted routes when that makes sense, but also willing to explore uncharted territory: When I explore uncharted territory, I tend to make charts as I go as much as I can. CBT for psychosis includes “off the map” exploration:


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