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Motivating Clients to Accumulate Positives

Alec Miller shares how to orient clients to the realities and benefits of introducing small, enjoyable experiences into their lives.

So one of the challenges of teaching emotion regulation skills, specifically in terms of accumulating positives, is that when working with depressed patients, they're saying, I don't feel like scheduling a pleasant activity. I don't have the urge to do it. I don't feel up to it. I don't have my mojo like I did before my depression. And I think you need to be prepared to tell them that they're not gonna feel it first. They're gonna feel it after. So we need to kind of schedule them with pleasant activities that can be self directed, activities engaging with other people. It doesn't matter. Hopefully a mixed diet of both is probably best. And notice how they feel before they do the activity, whether it be listening to some live music, whether it be going out for ice cream with their daughter, and how do you feel afterwards? And most of the time, based on my experience, my clients say I felt a whole lot better after I did some of these activities. And it's not to say every single activity generates massive amounts of pleasure and joy. But net net, you're gonna track which activities give them pleasure and we're gonna have them do more of those things and joy after they do them. And they will accumulate pennies in the piggy bank, positive feeling, positive feeling and they'll feel more mojo as they accumulate more of these positive experiences over time. So at the outset of the emotion regulation skills, I go out of my way when I'm teaching the ABC please skills to basically draw a scale on the board with one side of the scale weighted down and the other one kind of higher up, meaning not a lot in it. And I'm trying to highlight for my client or clients in a group what are the positive things that are happening in one's life and what are some of the negative things that are happening in one's life. And it turns out at the present moment when they're coming for therapy, the side that is weighted more heavily is certainly filled with more negatives. It could be health concerns. It could be financial concerns. It can be relational concerns. It could be mental health related concerns more broadly. And when those things are happening, there tends to be a dearth of positivity. But it doesn't have to be that way. If we can be thoughtful, mindfully proactive, and start to build in more positives and reduce our vulnerabilities, we can start to have the scales shift and then maybe over time even have it slightly imbalanced in the other direction, I hope. But it's important to kind of orient them to where is their life now and ultimately what is their goal so we can then add more positives, reduce their vulnerability to achieve a better emotion regulation set of skills.