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Cognitive-Behavioral Techniques Using Applied Improvisation-workshop handout

                  "The best way to have a good idea is to have a lot of them." Linus Pauling

What Cognitive-Behavioral Techniques and Applied Improvisation have in common:
  • Here and now focus
  • Collaborative
  • Goal-oriented or Problem-focused – what is it I am trying to do and what thinking gets in the way? What beliefs are guiding that thinking?
  • Aims to empower the client or student through skill development in cognitive agility, reality testing and shifting gears
To change our thinking from the negative to the positive requires effort and practice. Self-protective, defensive mental habits are easily formed by stressful events and triggered by perceived threats, even when the threats are coming from our own thoughts - when the call is coming from inside the house. Defensive, negative thoughts narrow the field of attention, while positive, creative thoughts expand it.

Cognitive-behavioral techniques exploit the brain's ability to form and rely on patterns by redirecting attention and mental activity to more positive and productive thoughts that have the power to become self-reinforcing. Because our brain rapidly forms and relies upon patterns, what we repeatedly think and do becomes part of our automatic thought process. Habits of mind become belief and can be astonishingly resilient. All sort of things can happen that could prove the belief wrong but the habits of mind will persist and keep it alive. 
The power of thoughts to shape mood and perception has a remarkable impact on what we think of as real. Depression, anxiety, chronic stress and trauma can produce mental patterns that negative, limiting and narrow in focus, but feel safe and inescapable. We become adept at framing and naming experiences according to these core thoughts, e.g. "My dreams will never come true so its better never to have them" as a repeated, self-protective thought turns into a genuine block to making plans or taking steps to realize goals, then a repeated pattern of roads not taken and a sense of being trapped in familiar ruts; "if something terrible happens to me I must deserve it" can induce sadness, guilt and the inability to move past a traumatic or painful event, which leads to abandoning self-care or changes that strengthen the "muscles" needed to avoid further victimization; "If I fail at something it would be better not to have done it at all" makes being a novice or beginner at some activity threatening to the extreme, so we experience paralysis when trying to do anything new.  
Dr. David Burns, a cognitive-behavioral specialist and author of Feeling Good: The New Mood Therapy identifies 3 core principles upon which Cognitive-Behavioral Therapy is based: 
1) All moods are created by our "cognitions" or thoughts;
2) When we are feeling depressed, thoughts are dominated by a pervasive negativity;
3) The negative thoughts which cause emotional turmoil nearly always contain gross distortions; 

WHY CREATIVE EXPERIENCES LIKE IMPROVISATION HELP CHANGE COGNITIVE PATTERNS
Habitual thoughts tend to feel true, even if a reality check proves them to be more mechanical than real, so shifting to a different thought process can feel uncomfortable, wrong, and false. To produce new neural pathways we have to think and behave in new ways long enough for a pattern to be established. This is a creative challenge, and creative experiences are very effective toward producing these patterns. While negative thoughts produce a sense of threat which narrows the field of attention, focusing attention on our strengths, gifts, supports and resources expands the field of
attention. Positive, collaborative, creative experiences garner our personal power, and when combined with action are even more engaging to the machinery of the brain. With practice and repetition, newly-developed ideas, roles, and beliefs eventually move from the cerebral cortex, where the conscious choice to make change begins, to the parts of the brain that manage simpler, more automatic processes. Neural pathways develop through this process of repetitive action and determine what will eventually become a “new normal.” 

The principles of Applied Improvisation directly connect to our ability to change the way we think through conscious awareness and creative choice-making. The way this works is summed up on the website www.happify.com, which specializes in research-based brain games:
"1. That the brain we're born with can be changed. Technically speaking, they call that neuroplasticity (You can teach an old brain new tricks.)
2. we can change it by adopting new thought patterns, by training our brain as if it were a muscle, to overcome negative thoughts.
3. All of us are hard-wired for negativity (blame evolution!) but can profoundly benefit from learning new ways to react and deal with everyday stresses.
4. It doesn't take a lot of effort to make a real difference in your life. A few simple and even entertaining mental diversions will change things."
GAMES
GROUP COUNT-UP AND COUNTDOWN
Objectives:
Focus the group on levels of energy produced through working together;
Express group connection without conversation or content;

The group stands in a circle and counts out loud from 1 to 10, going from very soft to very loud, then back down from 10 to 1 gradually lowering volume. Players should make eye contact and take cues from one another based on what they see and hear as the group goes through the process.
Round 2: The group counts out loud from 1 to 10 going from very relaxed to very intense, without going to highest volume, and then back down again.
Round 3: The group counts from 1 to 10 from expressing an emotional state of "good" to full-bodied joy, and then back down again.
Debrief - What were you aware of while doing this exercise? What was it like to connect in this way?

TALK IN NUMBERS
Objectives:
Interact using physical and emotional expression rather than words or cognitive content;
Focus on the moment to moment interaction among group members to tell a story without using words;
Explore a way to use imagination and emotion to collaborate;
Explore the concept of reality testing in cognitive-behavioral therapy using an improvisation game;

The group has a "conversation" using only numbers, starting at 1 and ending at 25. The idea is to have a dialogue that emerges from the choices the players make and how everyone builds on what others contribute. After the exercise is complete, discuss what everyone perceived was being discussed, the emotional arc, and how it ended. Compare how perceptions line up or are different and why. In therapy groups, this can be an opportunity for clients to reflect on their tendency to perceive things in a particular way that may stand out in contrast to others' ideas about what happened and explore how their perceptions shape reality in real life.

TALK IN NUMBERS- DYADS
Participants pair up and are assigned a relationship, e.g. Doctor/patient, or teacher/student and a decision the pair has to make. Using numbers from 1 to 25, the players have a conversation in those roles (who plays who can be assigned by the group if the decision is a complex one, or be discovered through the interaction). After the scene is complete, the group discusses what decision the pair came to, who was who, etc. 

CONFESSIONS
Objectives:
Explore specific response styles to high-stakes emotional content;
Examine the dynamic that develops as a result of each response style;
Explore the power of yes...and to expand and build dynamic interactions;
Practice making cognitive shifts within an interaction;
Examine the beliefs that are reinforced or impacted by the way others respond;


A team of 3 is established - a group of some kind, a family, 3 officers in a company - with the following roles: 
Advice-Giver/Answer Person - who always responds with advice, solves the problem or "has the answers"
Reactor - always responds with high emotionality, either negative or positive
Yes...ander - always responds by accepting what is said, and building on it in subtle ways.


A 4th player steps into the role of Confessor. This player makes an important confession to the team, e.g. "I have been embezzling from the company for 10 years" or "Everything on my resume is fake."
A 5th player holds a chime. 
 Each team members responds strictly within the role and the confessor and team members build on what transpires in the conversation. The player with the chime can play it any time, at which point the team rotates clockwise and takes on a different role. Each player must attempt to pick up the thread established by the player in the role before. 

Debrief: What was it like for the Confessor to experience each of these response styles? What emotions and/or thoughts were triggered or reinforced by these different responses? What was it like to shift quickly to another role? What was challenging or interesting about taking over a role established by someone else?

DATING GAME
Objectives:
Explore underlying beliefs that produce cognitive distortions;
Identify some of the beliefs that cognitive-behavioral techniques address;
Examine the behaviors and thoughts that result from fixed beliefs;

In the style of the Dating Game that used to be on television, 3 players take the role of men or women in a line-up of potential dates. A 4th player asks them questions. Each person in the line-up is given a fixed belief on a piece of paper and their responses should be improvised based on how a person who is coming from this belief would think and speak. As more is revealed over the course of the game, the interviewer attempts to nail down the belief represented by each player. The game is over when the interview identifies the belief of each one. This can also be done in teams, using the Dating Game format of asking fun questions on a theme. 

Some beliefs that can be used in this game:

I am so unlucky and there is nothing I can do to change that.

I deserve to be adored.

Nothing I do is ever appreciated.

No one must know how anxious I really am all the time.

Nothing ever works out for me.

I shouldn’t have to be the one who has to change.

Other people treat me very unfairly and that’s why I’m unhappy

Its too late for me to be try to be happy

If I fail at something, it would be better if I hadn’t done it at all

I peaked in high school

I can’t be happy unless my mother is happy. And she’s never happy.

I need someone else to notice and affirm me to have any direction in my life.

Admitting a mistake is a sign of weakness

It is never a good idea to admit to being happy.

A person’s talents and strengths are set at birth and cannot be changed. I wasn’t born with much.

I should be in control at all times.

I should be nice to everyone at all times no matter what.

I must make other people feel good at all times to have any self worth.

Nothing good is going to come of this.

If I get what I want I won’t know what to do with it. So its better if I don’t.

People will be jealous of me if I succeed. I can’t handle that. 

According to Dr. Burns, there are 13 procrastination and do-nothingism mindsets:
  1. Hopelessness
  2. Helplessness
  3. Overwhelming Yourself
  4. Jumping to Conclusions
  5. Self-labeling
  6. Undervaluing the Rewards
  7. Perfectionism
  8. Fear of Failure
  9. Fear of Success
  10. Fear of Disapproval or Criticism
  11. Coercion and Resentment
  12. Low Frustration Tolerance
  13. Guilt and Self-blame
READING
Cognitive-behavioral techniques were effective in reducing both psychological stress and physical pain in this study "Cognitive Behavioral Therapy Techniques For Distress and Pain In Breast Cancer Patients: A Meta-Analysis Journal of Behavioral Medicine

The Basic Principles of Cognitive-Behavioral Therapy by Judith Beck, Phd

Jude Treder-Wolff, LCSW, CGP, MT is a consultant/trainer and writer/performer. She is President of Lifestage, Inc which designs and facilitates creative professional development training and is approved by New York State as a Provider of Continuing Education for social workers, provider #0270. She is host/creator of (mostly) TRUE THINGS, a storytelling show that features true stories - with a twist - told by people from all walks of life, ages and backgrounds.


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