Self-talk Identification, Questioning & Revision (SIQR)
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Self-talk Identification, Questioning & Revision (SIQR) is a set of specific techniques within the general rubrics of cognitive-behavioral, experiential and “neuropsychological” therapies guided by late 20th and early 21st century research on brain function.
Contents
Therapeutic Objectives
As is the case with other cognitive therapies, the principle goal of SIQR is to assist the patient suffering from belief-induced anxiety, depression, compulsion, addiction or other unpleasant or troubling emotions and/or behaviors to look for, identify, examine, question and then revise, reformulate, or even wholly reject and replace the cognitive schemas that cause such emotions and behaviors. Unlike the earlier cognitive therapies, however, the precise methods are designed to trigger specific linkages of neural networks between various portions of the limbic systems and cerebral cortices in both brain hemispheres.
The neurological objective of SIQR is similar to that of eye movement desensitization and reprocessing (EMDR; see McNally, Ruoanzoin, and Shapiro) in that it attempts to link previously dis-connected emotional and sensory memory centers in one hemisphere with language processing locations in what is usually the opposite hemisphere. While EMDR stimulates via visual, auditory and tactile sensory channels, SIQR utilizes fine motor control and tactile sensory channels.
Developmental Influences
SIQR’s cognitive components point back to the Rational Emotive Behavioral Therapy (REBT) of Albert Ellis; the cognitive-behavioral therapy (CBT) of Aaron Beck, Arthur Freeman and Donald Meichenbaum; the cognitive appraisal therapy (CAT) of Richard Wessler, Sheena Hankin and Jonathan Stern; the multi-modal therapy (MMT) of Arnold Lazarus; the values clarification techniques of Sidney Simon; and the schematherapy (ST) methods of Jeffrey Young. Cognitive theoretical (belief system and value system) influences include the work of Noam Chomsky, Richard Lazarus, Alfred Adler (in Lundin, and in Mosac), Sigmund Freud and Anna Freud (specifically on defense mechanisms), Alfred Korsybski (on lingual symbolism), Julian Rotter (on locus of control), James Flavell (on metacognition), and Martin Seligman and Bernard Weiner (on attribution theory).
SIQR developer Rodger Garrett’s writing about cognitive therapy appears to most deeply rooted in Wessler’s, Hankin’s and Stern’s CAT. In his writing, Garrett often repeats the theme of core beliefs, values, idea(l)s, assumptions, convictions and attitudes influencing affective states (e.g.: anxiety, anger, depression, mania) that combine with the core schemata to influence perceptions, appraisals, interpretations, evaluations, assessments, analyses of, and attributions of meaning to, events in the environment (see Garrett online).
The therapy’s neurophysiological components are grounded in the work of Neil Carlson, Louis Cozolino, M. DeBellis, M. Driessen, R. Duman, Michael Gazzaniga, C. Heim, Paul Huttenlocher, Alfred Kaszniak, J. Kaufman, Joseph LeDoux, Jaak Panksepp, Mark Rosenzweig, Alan Schore, Daniel Seigel, Francine Shapiro, Otfried Spreen, M. Stein, Bessel Van der Kolk, E. Vermetten, Douglas Watt and other brain mapping and function researchers using computer-aided tomography, magnetic resonance imaging, proton emission tomography, small partial emission tomography and other brain scanning techniques.
Garrett’s interpretation of the sum total of millennial era brain mapping and functional research is similar to Shapiro’s with regard to her bi-lateral EMDR therapy: That specific methods can be used to link the affective memories of trauma stored largely in one brain hemisphere with the symbolic language processing centers in the opposite hemisphere (see Shapiro, 2001).
Method
SIQR is conducted in six phases:
- Motivational interviewing as per William Miller and Stephen Rollnick on a platform of client-centered principles (see Rogers) to develop a trust-based collaboration between therapist and patient.
- Indoctrination (usually by means of psychoeducational handouts) in cognitive behavioral concepts developed by Ellis et al., Beck et al., Meichenbaum, Seligman, Simon et al., Weiner, Wessler et al., and Young; in the concept of defense mechanisms originally developed by the Freuds; in the concept of theory of mind developed by Premack; in critical thinking as described by Ruggiero; the concepts of shame and guilt as described by Tangney and Dearing; and in the logical fallacies or errors of reasoning developed by Socrates and the Enlightenment philosophers.
- Indoctrination and introductory practice in the use of mindfulness skills (see Dimeff and Koerner, Hayes et al., Linehan, Kabat-Zinn, Ludwig, Marra, and Ogden) leading to capacity to place oneself in a state of conscious awareness of one’s momentary affects (emotions, sensations, feelings) for the sake of both distress tolerance and systematic desensitization (see Johnson, and Schiraldi).
- Usage of Ellis’s twelve “bad ideas” in the SIQR format of writing out with the non-dominant hand (preferred because of the stimulation of the motor and sensory neural networks in the non-dominant brain hemisphere usually associated with affect storage) or by typing (which, using both hands, has somewhat the same effect), then converting the original statement into a question asking “Is it true that…,” then asserting that the statement is true, then asserting that the statement is not true. The patient then switches to dominant handwriting (or continues to type) to report the affects experienced while writing the four versions of the “bad idea,” and follows that up with a brief essay on his realizations during the process. Examples of the process may be seen in numerous articles by Garrett available online.
- Usage of Beck’s and Freeman’s typical beliefs of the major personality disorders (as selected by the therapist) in the same fashion. The SIQR therapist who is solidly grounded in personality theory (see Clarkin and Lenzenweger, Ekleberry, Kelly, Livesley, Masterson, Millon, and Stone) may elect to draw from his or her understanding of the cognitive underpinnings of the personality disorders to develop new “bad ideas” for the patient to work through as described above. Several sessions may be devoted to this process.
- Development of the patient’s own notions of his logical fallacies based on evolving awareness (or “mindfulness”) into self-devised sentences to be worked through in the same fashion as stages four and five above.
Mechanisms of Cognitive and Behavioral Change
From psychodynamic or object relations standpoint (see Bion in Symington, Branden, Colby, Fairbairn, Freud in Gay, Horney, Karpman, Kernberg, Klein in Mitchell, Kohut in Siegel, Meissner, Miller, Scharff and Scharff, Searles, Sullivan, Sullivan in Evans, Winnicott, and Winnicott in Dodi), SIQR is designed to produce rapid movement from unconscious domination of cognition (or ego operations) by a punishing, ineffectual or otherwise dysfunctional superego introjected from behavioral modeling by early life authority figures including parents, older siblings, playmates, teachers, etc.
From an experiential (more or less "gestalt") standpoint (see Alpert, Laing, Perls, and Polster and Polster), SIQR is designed to demonstrate the connections between introjected but unconscious core beliefs, values, idea(l)s, assumptions, convictions and/or attitudes; the patient’s affects; and the patient’s perception, appraisal, evaluation, interpretation, assessment, analysis and/or attribution of meaning to events in his life.
From a behavioristic standpoint (see Hayes et al., Linehan, Skinner, and Watson), SIQR is designed to deliver a method – and rewarding and strong reinforcing experience therewith – to the patient that the patient can use when he or she experiences dysphoria in the future. Quoting Garrett quoting others, “Give a man a fish and he eats today; teach a man how to fish and he eats from now on.”
The combinations of psychodynamic and experiential revelations place the patient at ever-increasing capacity for conscious choice of behavior, as opposed to unconsciously automated, “knee-jerk” reactivity (see Bandura, Hayes et al., Linehan, and Mansell).
References
Alpert, R. (“Ram Dass”): Be Here Now, San Francisco: Lama Foundation, 1971.
Bandura, A.: Self-Efficacy: The Exercise of Control, San Francisco: W. H. Freeman, 1997.
Beck, A.: Cognitive Therapy and the Emotional Disorders, New York: Penguin-Meridian, 1976.
Beck, A.; Freeman, A.: Cognitive Theory of the Personality Disorders, New York: Guilford Press, 1990.
Beck, A.; Wright, F.; Newman, C.; Liese, B.: Cognitive Therapy of Substance Abuse, New York: The Guilford Press, 1993.
Beck, A.: Prisoners Of Hate: The Cognitive Basis of Anger, Hostility, and Violence, New York: Harper-Collins, 1999.
Branden, N.: The Disowned Self, New York: Bantam Books, 1976.
Carlson, N.: Physiology of Behavior, 7th Ed., Boston: Allyn and Bacon, 2001.
Colby, K.: A Primer for Psychotherapists, New York: Ronald, 1951.
Cozolino, L.: The Neuroscience of Psychotherapy: Building and Rebuilding the Human Brain, New York: W. W. Norton, 2002.
DeBellis, M.: Developmental Traumatology: Neurobiological Development in Maltreated Children with PTSD, in Psychiatric Times, Vol. 16, No. 11, 1999.
Dimeff, L.; Koerner, K.: Dialectal Behavior Therapy in Clinical Practice: Applications Across Disorders and Settings, New York: The Guilford Press, 2007.
Dodi, G.: In Search of the Real: The Origins and Originality of D.W. Winnicott, Jason Aaronson, 1993.
Driessen, M.; Herrman, J.; Stahl, K.; et al.: Magnetic resonance imaging volumes of the hippocampus and the amygdala in women with borderline personality disorder and early traumatization, in Archives of General Psychiatry, Vol. 5, No. 7, 2000.
Duman, R.: Neural plasticity: consequences of stress and actions of antidepressant treatment, in Dialogues of Clinical Neuroscience, Volume 6, 2004.
Ekleberry, S.: Seminar on Substance Abuse and Axis II Personality Disorders, San Francisco: Arcturus, 2000.
Ellis, A.; Harper, R.: A Guide to Rational Living, North Hollywood, CA: Melvin Powers, 1961.
Ellis, A.; Dryden, W.: The Practice of Rational Emotive Therapy, New York: Springer Publishing Company, 1987.
Ellis, A.: Overcoming Destructive Beliefs, Feelings, and Behaviors: New Directions for Rational Emotive Behavior Therapy, New York: Promethius Books, 2001.
Evans, F.: Harry Stack Sullivan: Interpersonal Theory and Psychotherapy, London: Routledge, 1996.
Fairbairn, R.: An Object Relations Theory of the Personality, New York: Basic Books, 1952, 1984.
Flavell, J.: Metacognition and cognitive monitoring: A new area of cognitive-developmental inquiry, in American Psychologist, Vol. 34, No. 10, Oct 1979.
Gay, P.: Freud: A Life for Our Time, New York: W. W. Norton, 1998.
Gazzaniga, M.; Ivry, R.; Mangun, G.: Cognitive Neuroscience: The Biology of the Mind, 2nd Edition, New York: W.W. Norton, 2002.
Hayes, S.; Follete, V.; Linehan, M.: Mindfulness and Acceptance: Expanding the Cognitive-Behavioral Tradition, New York: The Guilford Press, 2004.
Hayes, S.; Jacobson, N.; Follette, V.; Dougher, M.: Acceptance and Change; Content and Context in Psychotherapy, Reno, NV: Context Press, 1994.
Heim, C.; Nemeroff, C.: The role of childhood trauma in the neurobiology of mood and anxiety disorders: pre-clinical and clinical studies, in Journal of Biological Psychiatry, Vol. 49, 2001.
Heim, C.; Nemeroff, C.: Neurobiology of early life stress: clinical studies, in Seminar on Clinical Neuropsychiatry, Vol. 4, 2002.
Horney, K.: The Neurotic Personality of Our Time, New York: W. W. Norton, 1937, 1955.
Huttenlocher, P.: Neural Plasticity: The Effects of Environment on the Development of the Cerebral Cortex, Cambridge, MA: Harvard University Press, 2002.
Johnson, S.: Therapist’s Guide to Clinical Intervention: The 1-2-3’s of Treatment Planning, 2nd Ed., London, UK: Elsevier / Academic Press, 2004.
Kabat-Zinn, J.: Mindfulness Meditation: Health benefits of an ancient Buddhist practice, in Goleman, D.; Gurin, J., editors: Mind/Body Medicine, New York: Consumer Reports Books, 1993.
Kabat-Zinn, J.: Coming to Our Senses, Healing Ourselves and the World Through Mindfulness, New York: Hyperion, 2005.
Karpman, S.: Fairy tales and script drama analysis, in Transactional Analysis Bulletin, Vol. 7, No. 26, 1968.
Kaszniak, A., et al.: Toward a Science of Consciousness, Editions I, II and III, Cambridge, MA: MIT Press, 1996, 1998, 1999.
Kaufman, J.; Plotsky, P.; Nemeroff, C., et al.: Effects of early adverse experiences on brain structure and functions: clinical implications, in Journal of Biological Psychiatry, Vol. 48, 2000.
Kelly, G.: The Psychology of Personal Constructs; New York: Norton & Company, 1955.
Kernberg, O.: Severe Personality Disorders: Psychotherapeutic Strategies, New Haven, CT: Yale University Press, 1977.
Korzybski, A.: Science and Sanity: An Introduction to Non-Aristotelian Systems and General Semantics, 4th Ed., New York: Institute of General Semantics, 1958.
Laing, R. D.: Knots, New York: Penguin, 1973.
Laing, R. D.: The Politics of Experience, New York: Penguin, 1968.
Lazarus, A.: Brief but Comprehensive Psychotherapy: The Multimodal Way, New York: Springer, 1997.
Lazarus, R.: Emotion and Adaptation, New York: Oxford University Press, 1991.
LeDoux, J.: The Emotional Brain: The Mysterious Underpinnings of Emotional Life, New York: Simon & Schuster, 1996.
Linehan, M.: Cognitive–Behavioral Treatment of Borderline Personality Disorder, New York: Guilford Press, 1993.
Livesley, W. J.: Practical Management of Personality Disorder, New York: Guilford Press, 2003.
Ludwig, D.; Kabat-Zinn, J.: Mindfulness in Medicine, in Journal of the American Medical Association, Vol. 300, No. 11, September 2008.
Lundin, R.: Alfred Adler's Basic Concepts And Implications, London: Routledge, 1989.
Mansell, W.; Rigby, Z.; et al.: Do current beliefs predict hypomanic symptoms beyond personality style? Factor analysis of the hypomanic attitudes and positive predictions inventory (HAPPI) and its association with hypomanic symptoms in a student population, in Journal of Clinical Psychology, Vol. 64, No. 4, April 2008.
Marra, T.: Dialectical Behavior Therapy in Private Practice, Oakland, CA: New Harbinger, 2005.
Masterson, J. (editor/author): The Personality Disorders Through the Lens of Attachment Theory and the Neurobiologic Development of the Self, Phoenix, AZ: Zeig, Tucker & Theisen, 2004.
McNally, R.: Research on Eye Movement Desensitization and Reprocessing (EMDR) as a Treatment for PTSD, Washington, DC: Department of Veterans Affairs, 2004.
Meichenbaum, D.: Cognitive-Behavior Modification: An Integrative Approach, New York: Springer, 1977.
Meissner, W.: The Borderline Spectrum: Differential Diagnosis and Developmental Issues, New York: Jason Aronson, 1984.
Miller, A.: For Your Own Good: Hidden Cruelty in Child Rearing and the Roots of Violence, London: Farrar, Straus & Giroux, 1979, 1983.
Miller, A.: Thou Shalt Not Be Aware: Society’s Betrayal of the Child, London: Farrar, Straus & Giroux, 1981, 1984, 1998.
Miller, A.: Prisoners of Childhood / The Drama of the Gifted Child, New York: Basic Books, 1996.
Miller, W.; Rollnick, S.: Motivational Interviewing: Preparing People to Change, NY: Guilford Press, 2002.
Millon, T.; Grossman, S.; Meagher, S., Millon, C., Everly, G.: Personality Guided Therapy, New York: John Wiley & Sons, 1999.
Millon, T.; Grossman, S.: Moderating Severe Personality Disorders: A Personalized Psychotherapy Approach, New York: John Wiley & Sons, 2007.
Millon, T.; Grossman, S.: Overcoming Resistant Personality Disorders: A Personalized Psychotherapy Approach, New York: John Wiley & Sons, 2008.
Mitchell, J.: Selected Melanie Klein, Philadelphia: Free Press, 1987.
Mosac, H.: Primer of Adlerian Psychology: The Analytic - Behavioural - Cognitive Psychology of Alfred Adler, London: Routledge, 1999.
Ogden, P.; Minton, K.: Sensorimotor Psychotherapy: One Method for Processing Traumatic Memory, in Journal of Traumatology, Vol. 6, Issue 3, October, 2000.
Panksepp, J.: Affective Neuroscience: The Foundations of Human and Animal Emotions, New York: Oxford University Press, 1998.
Perls, F.: Gestalt Therapy Verbatim, San Francisco: Gestalt Journal Press, 1992.
Polster, E.; Polster, M.: Gestalt Therapy Integrated: Contours of Theory & Practice, New York: Vintage, 1974.
Premack, D.; Woodruff, G.: Does the chimpanzee have a theory of mind?, New York: Journal of Behavioral and Brain Sciences, Vol 1, 1978.
Rogers, C.: On Becoming a Person, Boston: Houghton Mifflin, 1961, 1995.
Rollnick, S.; Miller, W.: What is motivational interviewing?, Journal of Behavioral and Cognitive Psychotherapy, Vol. 23, 1995.
Rosenzweig, M.; Breedlove, S. M.; Leiman, A.: Biological Psychology, 3rd Ed., Sunderland, MA: Sinaur Associates, 2002.
Rotter, J.: Generalized expectancies for Internal vs. External Locus of Control of reinforcement, in Spielberger, C.: The Development and Application of Social Learning Theory, New York: Praeger, 1982.
Rouanzoin, C.: Using EMDR with Dissociative Disorders: Specific Protocols, Fullerton: Rouanzoin, 1999.
Ruggiero, V. R.: Beyond Feelings: A Guide to Critical Thinking, 4th Ed., Mountain View, CA: Mayfield Publishing, 1995.
Scharff, J.; Scharff, D.: A Primer of Object Relations Therapy, Northvale, NJ: Jason Aronson, 1992.
Schiraldi, G.: The Post-Traumatic Stress Disorder Source Book, 2nd Ed.; New York: McGraw-Hill, 2009.
Schore, A.: The Effects of a Secure Attachment Relationship on Right Brain Development, Affect Regulation, and Infant Mental Health, in Journal of Infant Journal of Mental Health, Vol. 22, 2001.
Schore, A.: Affect Dysregulation and Disorders of the Self, New York: W. W. Norton & Company, 2003.
Searles, H.: Countertransference and Related Subjects: Selected Papers, Madison, CT: International University Press, 1979, 1999.
Searles, H.: My Work with Borderline Patients, New York: Jason Aronson, 1986.
Seigel, D.: Toward an interpersonal neurobiology of the developing mind: Attachment relationships, “mindsight,” and neural integration, in Journal of Infant Mental Health, Vol. 22, 2001.
Seigel, D.: Reflections on the Mindful Brain, in Mind Your Brain, Los Angeles: Lifespan Learning Institute, 2007.
Seligman, M.: Learned Optimism: How to Change Your Mind and Your Life, New York: Knopf, 1990.
Shaprio, F.: EMDR: The Breakthrough "Eye Movement" Therapy for Overcoming Anxiety, Stress, and Trauma, New York: Basic Books, 1999.
Shapiro, F.: Eye Movement Desensitization and Reprocessing (EMDR): Basic Principles, Protocols, and Procedures, 2nd Ed., New York: Guilford Press, 2001.
Siegel, A.: Heinz Kohut and the Psychology of the Self, London: Routledge, 1996.
Simon, S.; Howe, L.; Kisrchenbaum, H.: Values Clarification: The Classic Guide to Discovering your Truest Feelings, Beliefs and Goals, New York: Warner Books, 1972, 1978, 1995.
Spreen, O.; Risser, A.; Edgell, D.: Developmental Neuropsychology, New York: Oxford University Press, 1995.
Stein, M.; Koverola, C.; Hanna, C.; et al.: Hippocampal volume in women victimized by childhood sexual abuse, in Journal of Psychological Medicine, Vol. 27, No. 4, 1997.
Stone, M.: Abnormalities of Personality Within and Beyond the Realm of Treatment, New York: W. W. Norton, 1993.
Symington, N.: The Clinical Thinking of Wilfred Bion, London: Routledge, 1996.
Tangney, J. P.; Dearing, R.: Shame and Guilt, New York: Guilford Press, 2002.
Van der Kolk, B: Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body and Society, New York: Guilford Press, 1996 / 2007.
Van der Kolk, B.; Hopper, J.; Osterman, J.: Exploring the Nature of Traumatic Memory: Combining Clinical Knowledge with Laboratory Methods; in Journal of Aggression, Maltreatment & Trauma, Vol. 4, No. 2, 2001.
Vermetten, E.; Schmahl, C.; Lindner, S.; et al.: Hippocampal and amygdalar volumes in Dissociative Identity Disorder, in American Journal of Psychiatry, Vol. 163, No. 4, 2006.
Watt, D.: Implications of Affective Neuroscience for Extended Reticular Thalamic Activating System Theories of Consciousness, in Emotion and Consciousness: The Association for the Scientific Study of Consciousness Electronic Seminar, 1998.
Wessler, R.; Hankin, S., Stern, J.: Succeeding with Difficult Clients: Applications of Cognitive Appraisal Therapy, San Diego: Academic Press, 2001.
Winnicott, D.: Human Nature, London: Routledge, 1990.
Winnicott, D.: The Child, The Family and The Outside World, 2nd Ed., San Francisco: Da Capo, 1992.
Young, J.: Cognitive Therapy for the Personality Disorders: A Schema-Focused Approach, 3rd Ed., Sarasota, FL: Professional Resource Press, 1999.
