Hierarchy of beliefs: starting with aspirations

In our training and treatment, we follow a somewhat different path from the usual cognitive behavioral approach. When we think of beneficial activities for the individual, we may start at the top of the belief hierarchy which is not operationally defined; specifically, purpose and meaning of aspirations. The purpose and meaning is conveyed by terms such as being engaged and living a useful, worthwhile and fulfilling life. The individual’s view of the self takes on the same meaning as the activity: being in charge of life, being worthwhile, and being fulfilled. We then ask the individual to visualize being involved in the aspiration. For example, having a home, friends, family, specific job, or engaged in a beneficial activity such as helping other people. Hopefully the individual will be able to experience an image of fulfilling the aspiration. We then inquire about the feelings being experienced in the here and now. When the aspiration is visualized, we look for feeling beliefs such as those listed above: being important, being in charge of life, being worthwhile. The idea behind this is to activate the adaptive mode. As I have pointed out previously, the specific goal or activity is not as important as the meaning of the aspiration/activity.

The individual should also be prepared to cope with the different obstacles, frustrations and disappointments they will encounter as they assume a more normal life. There are a number of exercises that can be used to increase the individual’s stress tolerance. For example, years ago I prepared a list of self-statements (rational responses) that individuals can use when they encounter the inevitable stressors of everyday life. These are essentially cognitive reframing of the situation. I have attached below some of the adaptive attitude statements which incidentally constituted part of the Dysfunctional Attitude Scale (DAS) as initially developed.

I would appreciate your comments on the above memo. Especially, which adaptive attitudes may be most helpful for our individuals.