This is a great activity I learned from one of my amazing professors at University of South Florida, Dr. Ryan Henry.  You can use it with a client or even with yourselves to better understand a problematic behavior and how best to make changes.  I facilitated this exercise with my Substance Abuse IOP clients.  One client, wrote such an incredible break up letter that we asked her to read it in other sessions.  The power that came from this woman when she read her letter was so moving, that not only did it help her make the necessary changes she needed to make, it inspired others to keep focused, and on track.  This client had spent many years feeling guilty over the death of her mother, and dealing with the effects of childhood abuse.  She normally presented in a very mild-mannered, polite and quiet way, but the day she read that letter; a new presence was unveiled.   The true spirit of this individual, free from the weight of addiction, guilt, and shame was released.  She smiled, she showed anger in a healthy way, she demonstrated confidence in her words, and most importantly – she believed what she wrote.   There is a really incredible feeling when working in group therapy.  The energy that is created that flows through people can be intoxicating – yet legal!  If you have never worked in treatment with groups I highly recommend trying it.   Check out the activity and comment to let me know if you like it, or if there are things you added that helped make it better.

ACTIVITY:  EXTERNALIZING THE PROBLEM

Identify a problem:

Give the problem a name:

Draw a picture of _______________.

Describe what ______________________ whispers to you to influence you:

When do you have more influence over ____________________?

When does ____________________ have more influence over you?

How do others support you in your effort to overcome ___________________?

How do others undermine your efforts to overcome ______________________?

Further exploration:

1) Have the client place the picture of the “problem” in a separate chair and talk about it or to it.  If their “problem” is seen as a character flaw, they may feel hopeless.  Role plays are also helpful with this activity.

When did it start?

How did it become strong?

What are the lies ___________ tells you to keep you engaged in problematic behavior (to keep you stuck)?

2) Have them write a break up letter to the “problem.”  Include the following in the letter:

Identify all the benefits of maintaining the relationship with the “problem” and all the great things (the payout – real or illusioned) they get from having this problem (avoid being hurt, blame to self, with certain addictions, “I feel better or good when I am high/drunk,” coping tool).

Explain why there is a need to break it off.  Have the client identify whatever positive benefit they are giving up and why it is okay; why it is more worth it (more important) to give it up then to continue to maintain the “problem”.  They make the decision in their letter.

Example:  Pornography addiction

Payout/Perceived Benefit – relief, feeling of importance, perceived connection with adult stars

Negatives – guilt, wasted time impact at work and home