Preparing for cognitive flooding

Today, we are pleased to present the live and unedited follow-up session with Madeleine, a loving mother who became terrified when she realized that her oldest beloved daughter might be in mortal danger during her hear abroad while in college.

We were a bit rushed near the end of M = Methods in Part 2 because of a mistake that I (David) made. I forgot that we had extended this webinar by 30 minutes, so we wouldn't be rushed at the end, so I wrongly concluded we were running out of time when we weren't!

In order to complete our work, we scheduled Part 3 several weeks later to do the following critical pieces of the work with Madeleine.

1. Additional work with the Externalization of Voices to make sure she could knock all of her self-critical thoughts out of the park.
2. Cognitive Flooding, using the magazine article she was triggered by to prompt the anxiety. The idea is to make yourself as anxious as possible for as long as possible, until the anxiety and panic eventually loses its punch and becomes boring. This will be one of the first times we have illustrated this technique live in a video-recorded session.
3. Any other loose ends that may have emerged since our first session with the wonderful Madeleine!

We did some cognitive flooding, urging Madeleine to close her eyes and describe her most terrifying fantasy involving her daughter's abduction by a sociopathy. We encourage her to make herself as anxious as possible, and within minutes she was at 100% and sobbing. Then we did some "memory" rescripting as we had promised her at the start, and part way through there was an unexpected surge of anger, that seemed to come from out of the blue, although the circumstances of the fantasy were clearly more than enough to trigger rage.

Using the technique called "Affect Bridging," I asker her whether the anger she was now feeling might trace back to some earlier traumatic event in her life, perhaps when she was young, and this was confirmed. She described a profoundly troubling indecent involve her mother and dad shortly before they got divorced.

There was a tremendous amount of emotion packed into today's follow-up session, almost non-stop, in fact. We look forward to seeing Madeleine's end-of-session Brief Mood Survey and Evaluation of Therapy Session. Jill and David assigned follow-up homework for her, including 15 minutes per day reading the terrifying article from People Magazine that had initially triggered her in the beauty salon.

We want to thank you, Madeleine for your courage in being so open and real, and for giving us all a unique opportunity for some incredible learning, and also the chance to get to know you at a deep a genuine level!

Thanks for listening to these three podcasts. We hope you enjoyed them and learned something useful and helpful, especially if you've also been struggling with feelings of depression and anxiety, or if you're a mental health professional wanting to take a deeper dive in to how TEAM CBT can sometimes produce extremely rapid healing, even from severe feelings of depression, anxiety, and despair.

Madeleine, Jill, Rhonda, and David

Following the session, Madeleine sent us the following feedback on the session via email:

Hi Jill and David,

Completed after session yesterday, but in my state of emotional fatigue, forgot to hit send!

Brief Mood Survey after session:

Depression: 3 / 20 (minimal)

Suicidal urges: 0 / 12 (none)

Anxiety: 8 / 20 (mildly elevated)

Anger: 9 / 20 (mild/moderately elevated)

Happiness: 12 / 20 (low)

Relationship Satisfaction: 29 / 30 (nearly perfect)

Evaluation of Therapy Session

Empathy: 20 / 20 (perfect score)

Helpfulness: 20 / 20 (perfect score)

Satisfaction: 8 / 8 (perfect score)

Commitment: 8 /8 (perfect score)

Neg feelings: 4 (high, range = 0- 4)

Difficulties with Q: 2 (medium, range = 0- 4)

What did you like the Least: exposure was pain. It feels very heavy and exhausting. And i understand, necessary to healing.

What did you like the Most: David's "bridging" my affect states to discover my rage source. Jill's keeping us on track and making connection from my present worry about daughter's safety to past feelings of betrayal, losing trust, and resulting anger in my dad, a trusted figure. You both hit the nail on the head so many times in the session to uncover the deeper, ugly, messy, dark pools that lie within me i choose to keep safely sealed tight and out of the light.

Postscript: I just completed day 1 of exposure in re reading the awful article. All the anxiety and fear resurfaced along with new feelings of revenge, determination, appreciation for the authors who are perhaps trying to help the family by publishing this. Ick.

Best Regards,

Madeleine

Again, a big thanks to you Madeleine, and we will watch closely as you continue your courageous daily exposure work, and look forward to the day when you have won this battle!

Warmly, david