think it matters. If I am writing, I repeat my client’s thoughts out loud as I write. I find that this encour- ages my client to start thinking about his thoughts, rather than just experiencing them.
Let’s see what Suzanne’s worksheet looks like.
Understand Your Reaction
Situation Feelings(Rate 1–10)
Physical Reactions (Rate 1–10)
Behaviors Thoughts
What? Who?
Where? When? What did I feel? How did my
body react? What did I do? What did I think?
Principal invited me to barbecue with the three other new teachers
Nervous (7) Worried (8) Embarrassed (6)
Clenched stomach (4) Tense shoulders (5)
Has not
responded • I don’t want to go.
• The other new teachers will be there.
• I won’t fit in.
• I will just stand there looking awkward.
• No one will want to talk to me.
• I will probably get all sweaty.
Agenda Item #2: Helpful Questions
Sometimes when you ask your clients what they are thinking, they respond with thoughts that are not hot thoughts. For example, Raoul felt very awkward going to the lunchroom. When his therapist asked what he was thinking, he responded, “I don’t know, I just feel awkward.” His therapist needs to ask additional questions to help Raoul identify his thoughts.
• How is this situation a problem for you?
Initially, I felt very awkward using these questions. My clients had just told me about an emotion- ally difficult situation, and I was asking what it meant to them or why it was a problem. However, I have consistently found these questions to be very helpful. Like all questions, it is important that you use a gentle, curious tone that conveys your desire to understand your client’s experiences.
Let’s go back to Suzanne. Her therapist decided to keep exploring, using the additional questions identified above, in order to be sure she fully understood why Suzanne found the invitation to the bar- becue so distressing.
Therapist: I want to be sure I understand what it is about the invitation to the barbecue that is so distressing for you.
Suzanne: It’s not the invitation, it’s going there with all the other new teachers.
Therapist: What is it about being there with all the other new teachers that is so distressing for you?
Her therapist uses one of the questions to keep probing what the situation means to Suzanne.
Suzanne: It’s hard to figure out. I guess that I won’t fit in; (pausing) I think my biggest fear is that they won’t want to be my friend.
Therapist: Sounds like the big fear is “they won’t want to be my friend”?
Suzanne: That’s right, that no one will want to be my friend, and I will be there all alone.
In the example above, the question “What is it about this situation that is so distressing for you?”
helped Suzanne figure out her underlying thought. Let’s look at another example and see how you can use these questions.
Your Turn!
What Does This Situation Mean to Suzanne?
In her fifth session, Suzanne wanted to focus on her feelings at recess. She was increasingly anxious and uncomfortable during recess duty and had been trying unsuccessfully to avoid it completely. Her thera- pist asked if Suzanne could give an example of what happens. Suzanne explained that she stands alone in the schoolyard, does not talk to anyone, and tries to look as if she is supervising the children. She feels very lonely and wishes the other teachers would talk to her. Suzanne adds that this exact situation happened yesterday. Her therapist believes this is a good situation to work with. She knows Suzanne’s feelings (anxious) and her behavior (she stands alone). She wants to understand Suzanne’s thoughts.
Therapist: When you are standing in the schoolyard at recess, what are you thinking?
Suzanne: (looking sad) None of the other teachers are talking to me.
Suzanne’s thought is a fact. It does not indicate what the situation means to Suzanne.
Look at the three possible responses below and pick the one that will help Suzanne identify what the situation means to her.
1. Help me understand what it is about the other teachers not talking to you that is a problem for you.
2. Have you tried talking to them?
3. What do you feel when the other teachers don’t talk to you?
Response #1 is the best answer to help Suzanne identify what the situation means to her and to help Suzanne identify her hot thoughts. Response #2 starts problem solving, and response #3 takes therapy into a different direction.
Therapist: Help me understand what it is about the other teachers not talking to you that is a problem for you.
Suzanne: The main problem is that I stand alone, while all the other teachers stand with a friend and talk to each other.
Look at the three possible responses below. Choose the response that will help Suzanne explore what the situation means to her.
1. When the other teachers don’t talk to you, how do you feel?
2. What does it mean to you that you are standing alone, and the other teachers are standing with a friend and talking to each other?
3. When you say the other teachers don’t talk to you, how many other teachers are outside at recess?
Response #2 is the best response to explore what the situation means to Suzanne. Response #1 would be a good response if you wanted to identify her feelings, and response #3 would be a good response if you wanted to understand the situation.
Therapist: What does it mean to you that you are standing alone, and the other teachers are standing with a friend and talking to each other?
Suzanne: It means that the other teachers don’t want to talk to me, because none of them approaches me.
At this point, Suzanne has identified a hot thought that explains her distress at recess. Her hot thought The other teachers don’t want to talk to me is a thought about others. Her therapist could con- tinue using the “Just Ask” questions and the questions about the meaning of the situation to explore whether there were other hot thoughts.