Outline

Shame, Guilt and Motivational Apathy as Impediments to Clinical Progress​

• Therapy as a trigger and affect avoidance
• Clinical impasses (underutilization, stagnation, premature termination)
• Shame, guilt and a sense of not-deserving
• Secrets from self and from therapist

Tools for Catalyzing Progress in Therapy

• Normalizing, de-pathologizing, un-diagnosing
• Dialectic reframing & evolutionary psychology
• Mindfulness & metacognition
• Self-acceptance & self-compassion
• Neuroplasticity of internalization

Shame: Clinical Techniques to Move Therapy Forward

• Debunking the myth of self-sabotage
• Manage outside judgement with a self-referenced identity
• Techniques to negate sweeping generalizations
• Foster self-forgiveness with motivational innocence

Guilt: Help Clients Overcome the Debts of Guilt

• Differentiate guilt from regret
• Ordinary perfection & self-acceptance
• Master the fear of making mistakes

Self-Doubt, Dilemmas & Indecision: Interventions for Clients Paralyzed by Uncertainty

• Normalizing strategies to dissipate self-doubt
• Manage the anxiety of unpredictability with uncertainty training
• Make decisions easier with the art of arbitrary choice
• Reframe a dilemma as a choice between two rights

Motivational Apathy & Self-Inefficacy: Strategies to Improve Motivation and Autonomy

• Find a reason-to-change with the change equation
• Techniques that leverage intrinsic motivation
• Find freedom-to-change with Choice Awareness Training (CAT)
• Pattern interruption for habit change – get clients off autopilot

Self-Criticism and Self-Stigmatization: Quiet Your Client’s Inner Critic

• Varieties of self-deprecation (self-criticism, self-loathing, etc.)
• Techniques to reframe symptoms as strengths
• Compassion exercises for problematic habits of self-care
• Recover from the disease model

Working through Affect Avoidance

• Exposure, mindfulness & metacognition
• Top-down & bottom-up emotional self-regulation
• Cue-conditioning of self-Regulation

Connect Specific Strategies to the Treatment of:

Trauma

• Damaged goods, survivor’s guilt & avoidance of conflict
• Somatic interventions to restore the original goodness
• Strategies to survive without guilt
• Conflict avoidance: Paper tigers v. real tigers
• Exercises to rediscover self-worth

Stress and Anxiety

• Mediate the paralysis of perfection with self-acceptance
• Non-neurotic, stress-free perfectionism
• Social anxiety as shame & self-doubt: disapproval inoculation & self-referencing
• Mindfulness-based, non-anxious self-consciousness

Emotional Eating & Binge Eating

• How shame pushes clients into binge eating
• Choice Awareness Training for moderation & presence
• Self-acceptance strategies for emotional eating
• Transcend body shame by dis-identifying from the physical

Anger

• Shame of fear: Shame as a cover for anger
• The vicious guilt-anger loop
• Self-acceptance techniques for internal damage control
• Compassion exercises to let go of anger

Depression

• Depression as self-exile
• Shame as a risk factor for suicide
• Mindfulness for managing rumination
• Metacognitive silence: From negative self-talk to selfaccepting non-talk

Substance Abuse

• Addressing the shame of relapse
• Self-assertive trigger avoidance
• Choice awareness techniques for habit modification
• Build craving/impulse control skill power

Betrayal, Secrecy & Deception

• Separation & divorce as self-care & progress
• Secrets from therapist without rupture of rapport
• De-pathologizing the motives behind lying & deception

Research, Limitations and Potential Risks