Problem Check List  mentalhelp.net/psyhelp/chap2/chap2c.htm

Place a check mark in front of every goal or problem you would like to work on. Then go back and decide on what to work on first. Recommended readings in this book are given in parentheses.

I. I want to change my overt behaviors or my thoughts, such as:

____  stop a bad habit--smoking, drinking, drugs, over-eating, swearing. (Ch 4, 11) and try to deal with underlying feelings

____  overcome behavior problems--lying, stealing, deceiving, laziness. (Ch 3, 4, 11, 12) and look for underlying feelings

____  study or work more, have more self-control and less procrastination. (Ch 3, 4 and 11)

____  be more caring, giving, affectionate. (Ch 3, 4, 9, 11) and look for interfering feelings

____  be more or less socially outgoing. (Ch 4, 11, 13 and 14)

____  improve a friendship or an intimate or love relationship. (9-11)

____  reduce excessive worries or obsessions or jealousies. (Ch 4-12)

II. I want to change my conscious emotions, specifically:

____  afraid I'll hurt myself or someone else or have a nervous breakdown (go get professional help right away).

____  anxious, fearful, tense, shy, up tight, poor sleep. (5, 12 , 13 14)

____  overwhelmed, confused, bewildered, lost. (Ch 3, 5, 9 and 12, and this may be a problem that needs professional help)

____  depression, loneliness, sadness, guilt, feeling a failure.(6,12,14)

____  resentment, anger, distrust, feeling betrayed, wanting to hurt someone. (Ch 7, 9, 10, 12 and 14)

____  unexplained changes in mood, mood swings of highs and lows. (Ch 6 and 12)

____  physical complaints, aches and pains, tiredness, poor appetite. (Ch 5, 6 and 12)

____  don't give a damn, apathy, feeling that nothing matters. (Ch 3, 4, 11 and 14)

____  overly eager to please, an unquestioning and obedient follower. (Ch 8, 13 and 14)

III. I want to gain certain skills so I can handle problems better:

____  be a good listener, empathic, able to disclose my true self (9, 13)

____  stand up for my rights, refuse to be taken advantage of. (Ch 8, 13 and 14)

____  make good decisions, avoid impulsive or uninformed choices. (Ch 4, 11, 13 and 14)

____  how to meet people, social and dating skills. (Ch 9, 13, 14)

____  study or test-taking skills, how to concentrate better. (Ch 13)

____  time management, scheduling, reducing procrastination. (Ch 3, 4, 11 and 13) and work on underlying needs

____  leadership and persuasion skills. (Ch 13)

____  parenting skills and relating to children better. (Ch 4, 9, 11)

____  handling money, budgeting, controlling impulsive buying. (Ch 4, 11 and 13) and figure out underlying emotions

____  choosing a career, planning out my life, making educational plans. (Ch 3 and 13)

____  learn how to deal with sexual problems. (Ch 10)

IV. I want to change the way I think, more specifically:

____  become more hopeful or optimistic, less negative view of the world. (Ch 6 and 14)

____  be more tolerant of others or myself, more accepting of what is. (Ch 7, 9 and 14)

____  be more willing to try something different, more brave, adventurous. (Ch 4, 8, 11, 13 and 14)

____  reduce my own attitudes or expectations or views that upset me. (Ch 6, 9 and 14)

____  learn to think straight and logically, stop deceiving myself. (14)

____  learn positive mental attitudes, self-suggestions, self-hypnosis.  (Ch 14)

____  take more responsibility for my problems, their solution & my life. (Ch 3, 8 and 14)

____  develop a philosophy of life and learn how to live by it. (Ch 3, 4, 11 and 14)

____  increase my motivation, overcome my reluctance to change & work hard. (Ch 3, 4, 11 and 14)

V. I want to understand what makes me tick, why I do the things I do, the unconscious motives and dynamics within me:

____  uncover and understand the past experiences that still bother me. (Ch 9, 14 and 15)

____  become more aware of my self-deceptions and defense mechanisms. (Ch 5, 9, 14 and 15)

____  recognize the "games" being played by me and by others. (Ch 9 and 15)

____  get in touch with the conflicts and repressed feelings inside me. (Ch 9, 12 and 15)

____  remember and understand my dreams or daydreams. (Ch 15)

____  realize the continuing impact of my family life & early experiences. (Ch 9, 14 and 15)

____  understand my needs--dependency, aggressive, sexual, etc. (Ch 7, 8, 9, 10 and 15)

Table 2.2: For the Hesitant Self-Helper--How to Move from Avoidance to Contemplation to Commitment

Most self-improvement is made by people changing themselves, not by people seeing therapists or attending 12-step groups. Self-help is the most common approach with both easy changes and with very tough ones, including smoking, drinking, and even heroin use (at least in veterans returning from Vietnam). When these self-improvers are asked, "How did you do it?" they often say "I just decided." Maybe there is more wisdom in this comment than we realize at first. It is quite possible, in certain situations, that "just deciding" is the core of the problem. Indeed, for some people, once the decision is definitely made that "I'm going to change," their planning and self-change skills are quite adequate (or, perhaps, any old plan will work) and they simply change. The indecision or ambivalence (between changing and remaining the same) may often, in these cases, be the major problem (Miller & Rollnick, 1991).

On the other hand, most tough self-change projects are not just a matter of deciding "I'll do it." Making significant changes in our habits, feelings, beliefs or attitudes usually require more than will power, namely, extensive knowledge about self-help methods (which may be learned by reading or by trying to change and failing over and over again). And, we also need to learn how to be well motivated and optimistic.

Overcoming the denial of a problem

Denying your problem is appealing because it is easy, there is nothing to do, you can't fail, you can blame others, and others quickly see your resistance to changing so they stop bugging you. We also use a variety of excuses for doing nothing, such as "you can't get better until you hit bottom," "I've tried everything," and "people can't change." Amazingly, many people think self-change is impossible, including an estimated 2/3rds of our physicians. Notice how we expect experts to change us but not ourselves. That's nonsense.

What are the barriers we need to overcome in the process of "just deciding?" For the person who hardly thinks about making a needed change, the common barriers are (1) a reluctance to admit the problem ("I'm only 10 pounds overweight," "I'm just big boned," "It came from having babies," "My wife is overweight too," etc.). (2) Rebellion against pressure ("I hate it that Mom makes me study before dinner," "I like the way I've been teaching, this new cooperative education is nonsense," "I hate it when he/she mentions my weight when we are making love," etc.). (3) Resignation to staying the same ("I can't do anything about it," "I've tried to quit a 1000 times," etc.). (4) Feeling a victim and believing that someone else is responsible for your troubles; therefore, THEY owe it to you to fix it! You shouldn't have to do the work of changing (Dombeck, 2000). (5) Rationalizing that the problem behavior is really all right ("I know smoking isn't good for you but I only smoke 15 a day and usually I don't inhale and I smoke "light" cigarettes and I didn't start until I was 25 and my grandpa smoked 2 packs a day until he was 95 and I need them to relax but I'm going to quit!"). These are the kind of obstacles you face--they are powerful.

What can we do about our avoidance and denial? First, we can become aware of our use of excuses and mental tricks to avoid changing. Certain personalities consistently use specific defenses, e.g. if someone said something demeaning about you and you responded by laughing it off or saying "they didn't really mean it--no big deal," you are probably prone to use denial or minimization. If you responded by saying "that person is just mean-spirited, besides you can't please everybody--these things happen" or "there are deep psychological reasons why he/she said what he/she did," you are a rationalizer or an intellectualizer. If you boiled over, verbally or physically attacking the person or assuming they are totally evil, you are "externalizing" the causes of the problem. If you became self-critical and felt blamable for his/her opinion, you are "internalizing" the causes of the problem. In short, learn what defense mechanisms you use (see Ch 15) and do something about it, e.g. force yourself to face upsetting problems, avoid explaining away criticism of you, empathize with others (even critics), find less destructive ways to vent your anger, avoid feeling totally responsible for every bad happening, etc.

Second, the obvious solution to denial is to open your mind in many ways but this may not be easy. You must find good, persuasive reasons for changing. You must face reality and come to truly believe that the desired goals are well worth the cost of changing. This means you admit the problem, see its seriousness, and face the worries and fears involved in remaining unchanged. Caution: Research has shown that concentrating on the bad aspects of some behavior causes us to be unhappy and to want to change, but it doesn't lead to change (Beike, 2000). To take action and change, we must also see the advantages of improving and believe we can make the self-improvements we need. In other words, we have to get intimate with the problem and learn about it, not avoid thinking about it. And we must believe in our own self-control. How do you do both?

Miller and Rollnick, who deal with addictions, have developed questions to help us see our problems more fully (these interviewers have found that frank accusations and threatening confrontations by others frequently don't work, our defenses go up and our denial works overtime):

To see the problem--

What makes you think this is a problem?

What difficulties have you had related to this problem?

How have you been harmed by this problem? Have others been harmed too?

What things might happen if you continue doing this?

Do you have lots of reasons why you don't want to change this behavior?

To clarify your feelings--

How do you feel about this problem? How strongly do you feel?

What worries you about the future if you don't make a change? How concerned are you?

How do you feel about yourself and your unwillingness to change up until this point? or

How do you feel about getting into this situation and not getting out before now?

To determine if you are really interested in changing--

Can you summarize your reasons for making a change?

What reasons are there for remaining the way you are? (pay offs for the "problem" behavior)

Considering the pro and cons, how strongly do you want to change?

What is keeping you from making a firm, specific commitment to changing right now?

To see how optimistic or pessimistic you are about making the desired changes--

If you decide to try to change, how confident are you that you could do it? (Give your reasons)

Do you have some ideas about how to make the changes? Will you need any help?

Have you read about self-help methods for changing? or about therapies for changing?

Do you know other people who have made these changes?

When will you start?

The idea is to maximize in your mind the gap--the distance--between changing and staying the same. The greater the advantages of changing, as you see it, the greater your motivation. This is a crucial start. Reading more about your problem and its development, hearing more about other people solving a similar problem, and learning more about various methods of attacking the problem should give you even more hope and determination to get the job done. If you can't become firmly convinced to change and find yourself making a lukewarm attempt, you will probably not succeed. If changing doesn't seem worthwhile, maybe you should seek professional help or talk with a successful self-helper. Others can help you think more about the above questions and your future. You need determination to change.

Third, other people are often a crucial factor in determining if we change or not. Some people encourage our bad habits, e.g. an enabler minimizes our problem and doesn't confront us, instead they help us neglect or cover up the problem because they are afraid of straining the relationship. So avoid enablers. Helpers gently help us think about our problems and the solutions; yet, they don't push us into premature action. Admit your reluctance to change to a helpful friend and ask him/her to share his/her view of your defenses and your reasons for avoiding changes. This could be an eye opener. Also, look carefully for helpful programs in your community, such as self-help groups, anti-smoking programs, weight loss support groups, exercise programs at work, and so on. These are great opportunities to increase your awareness of the problems, see your choices, and get more arguments and support for making changes. Friends, programs, or groups will help get you started, and, likewise, arranging continuing support will help keep you on track: work with a buddy, report your progress to your doctor or helper every few days, have someone check up on you every week, tell lots of people what changes you are trying to make and ask them to keep asking you about your progress, etc.

Thinking of the "pros" comes first but once you are seriously contemplating changing, you also need to focus on accepting and/or decreasing the "cons" of changing. You need to compensate for your losses. Examples: If by giving up smoking you are losing a way to relax, you need to develop other ways calm down when tense. If drinking less is taking you away from your drinking buddies, you need to cultivate new friends or interact with them when they aren't drinking. If studying more is reducing your time with your friend, arrange to have an especially good time during the time you have together. If becoming more assertive and independent is creating some stress with your partner and causing some loneliness, you may need to "work it out" with the partner and become more involved with friends you enjoy. Taking care of the "cons" will reduce the tendency to backslide.