Theory and Practice of Contemporary Psychotherapies
Adlerian Therapy Role-Play-Push-Button Technique Video Transcript
Dr. Todd Grande: Hi [inaudible 00:00:14], how are you doing?
Michelle: I'm okay.
Dr. Todd Grande: Are you okay?
Michelle: Okay.
Dr. Todd Grande: I was hoping today if you're okay with it, we could try a particular technique that I think will help you to exercise and understand how you can somewhat control your emotions.
Michelle: Okay.
Dr. Todd Grande: Would you be okay with trying that?
Michelle: Sure. Yes.
Dr. Todd Grande: A part of this technique can be a little distressing in some situations. If it becomes too distressing, just stop and tell me to stop, and we'll move on to something less distressing.
Michelle: Okay.
Dr. Todd Grande: Are you okay with that?
Michelle: Yes.
Dr. Todd Grande: All right. This is called the push-button technique and it has two parts. I'm going to want you to reflect on two different images and tell me as you're reflecting on the image, what you're feeling like right now in this moment as you're feeling and to some extent, what you're thinking.
Michelle: Okay.
Dr. Todd Grande: The first image I want to be more negative image. All right. An image that maybe in your case because we talked about anxiety, maybe the image that provokes anxiety.
Michelle: Okay.
Dr. Todd Grande: Do you have an image that might work for that in mind?
Michelle: Yes.
Dr. Todd Grande: What's that?
Michelle: Seeing a spider.
Dr. Todd Grande: Seeing a spider?
Michelle: Mm-hmm (affirmative).
Dr. Todd Grande: Not a big fan of spiders?
Michelle: Terrified.
Dr. Todd Grande: Terrified especially.
Michelle: Terrified.
Dr. Todd Grande: It's a strong reaction.
Michelle: Yes.
Dr. Todd Grande: All right. Can you imagine in kind of a concrete way an encounter with a spider.
Michelle: Yes. I just encountered one this week so …
Dr. Todd Grande: Just this week?
Michelle: Mm-hmm (affirmative).
Dr. Todd Grande: All right. Go ahead and give it a few seconds and recall that image, and play that back a little bit. Then tell me what you're experiencing.
Michelle: My chest is heavy. My heart's pounding. I just want to jump up and leave the room.
Dr. Todd Grande: All right. A lot of anxiety.
Michelle: Yes, a lot.
Dr. Todd Grande: We talked before in other sessions about scaling where anxiety can be scaled from one which is no anxiety, to ten which is the most you've ever experienced in your life. Where are you right now with your anxiety?
Michelle: I'm five or six.
Dr. Todd Grande: It's like a moderate level.
Michelle: Yes.
Dr. Todd Grande: All right. You have a feeling of anxiety and a thought that you could just jump out of this chair and run out of the room.
Michelle: Yes.
Dr. Todd Grande: All right. This is a bit scary for you.
Michelle: It is. I am terrified.
Dr. Todd Grande: You're terrified.
Michelle: I don't see one, but thinking of one and thinking of past experiences, yes, I get very anxious.
Dr. Todd Grande: All right. Having that image in your mind.
Michelle: Mm-hmm (affirmative).
Dr. Todd Grande: All right. Let's move away from that.
Michelle: Okay.
Dr. Todd Grande: All right and we'll move to the second phase of the push button technique and for this face I want you to do the same thing except the image will be one that you associate with being satisfied, happy, not anxious. One thing because may be more of a sense of belonging, achievement, something oriented in that direction.
Michelle: Okay.
Dr. Todd Grande: Anything you could think of that would be a suitable image for a positive image?
Michelle: When I was around 40, it's more of a milestone in that time of my life. I was entering grad school and just being happy where I was at in my life at that point in time.
Dr. Todd Grande: What's that feel like right now as you recall that milestone?
Michelle: Content, I'm happy, relaxed.
Dr. Todd Grande: How much your anxiety level?
Michelle: I'll be a one.
Dr. Todd Grande: One?
Michelle: Mm-hmm (affirmative).
Dr. Todd Grande: Much different than you thought a few moments ago.
Michelle: Absolutely, completely different.
Dr. Todd Grande: Is there anything that you think that you've learned from exercising this technique looking at both sides?
Michelle: Well, if I think of something a negative or a bad experience, it produces anxiety or how I felt actually when I see the spider. Then when I had to think about the milestone at what it represented and how my life was, I nearly was happy and felt happy and was thinking of all the positive that that represented in my life and it just completely calmed me.
Dr. Todd Grande: These images both in the negative and the positive and the thoughts that are associated with images can have a fairly profound effect on your mood.
Michelle: Yes.
Dr. Todd Grande: You picked up what I was hoping you would pick up, which is that we have a good deal of control through the choices we make in terms of what images we want to focus on, what images we want to bring to the forefront. We can exercise control over emotions. That make sense?
Michelle: It does now that I've had to compare the two.
Dr. Todd Grande: What I'd like you to do between now and when I see you again is let's not worry about any more negative images.
Michelle: Okay.
Dr. Todd Grande: Let's try to avoid those and think of some more positive images particularly where you can do at any time but particularly … Or you can do it anytime, but particularly when you feel like your anxiety might be becoming a little escalated.
Michelle: Okay.
Dr. Todd Grande: Okay. I think it's good to have those images spelled out in advance, like that milestone is one. That's one that I think you're content.
Michelle: Mm-hmm (affirmative), yes.
Dr. Todd Grande: That could be a powerful anti-anxiety type of feeling, right? That image is consistent with not being anxious. If you have some others that you could have ready and think of it, there's just like technique as described, push button, right? You're bringing that image in and you're experiencing the emotion associated that image.
Michelle: Okay.
Dr. Todd Grande: All right. Just like pushing a button. You push a button, the image comes up, and you can even think of it that way. Then you have what I hope would be a more pleasant emotional reaction.
Michelle: Okay. Yeah, I think I can try that.
Dr. Todd Grande: You can try that? Does that make sense?
Michelle: Definitely. Yes.
Dr. Todd Grande: Okay. Try that out it as needed, again especially when anxiety is getting a little elevated, and then I'll see you again next week and we'll build from there.
Michelle: Okay.
Dr. Todd Grande: Thanks for it.
Michelle: Thank you.