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Superordinate Skills: Inside Outside Problem

Dimension 1: Inner-outer problem

Referring to diagram below: It is useful to imagine an external problem (other people, the car crash, the fight, the sacking, the lost husband, the death and so forth), AND an internal problem (feelings, defenses, moods, sensations in body, past memories, thoughts and so forth). Clients want to discuss the external problem at length, it transfers responsibility, it's safer or maybe they don't realize their role in creating the distress from the inside view.

Dimension 2: Negative-positive pole

After shifting the focus to the inner problem it is initially useful to discuss many of the negative aspects of this inner problem. This is vital because we need to know the parameters as to how this is a problem for them. Later however, we can move or at least refer to the positive, ideal outcome. If we don't do this we don't know what they are seeking as a goal. (To reverse a negative is not a visual, positive goal, eg I don't want to feel anxious.) Work the negative-positive poles of the problem back and forth in your sessions and always have them in your own head. It even helps to select a therapeutic modality for you.)

Basic Dimensions of Therapy