2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43
Therapy on paper
Formulate your request as detailed as possible
Describe the problem
Describe your expectations - what should happen as a result of therapy / coaching / training
Minimum program
Maximum program
Please select symptom for healing: bodily reaction, emotion, clamps, destructive habit, etc.
Write down
What emotionally significant events preceded the onset of the symptom (1-6 months earlier), personal, family, business, sexual, existential, spiritual, social, trauma, shock, etc.
How often does the symptom occur?
Where, with whom, what launches it?
In what situations does it aggravate? What kind of people? After what stress? Before what tests?
Emotional Background
What mood do you spend more time in? _
What do you feel more often when you are in a bad mood? _
Do you often feel
Resentment constantly often sometimes almost never
anxiety or fear constantly often sometimes almost never
sadness, depression constantly often sometimes almost never
anger constantly often sometimes almost never
pain constantly often sometimes almost never
powerlessness constantly often sometimes almost never
injustice constantly often sometimes almost never
guilt constantly often sometimes almost never
Your options:
Monitor your mood for several days / weeks - add notes
What would you like to become as a result of the course
If the course meets ALL your expectations
what will change in your life?
Imagine that a miracle can happen in your life as a result of the course. What was that?
Your attitude:
It won't work
I doubt
maybe
Later
I will do everything in my power until I am convinced that nothing will work out
Will do my best, make improvements anyway
I will succeed
For sure
Your option
How actively are you willing to participate in therapy?
What will you do to get the maximum benefit and pleasure?
What do you expect from the host?
Write down your questions and comments
QUESTIONS
ANSWERS
Mental health history: disorders, symptoms
_
Have you visited a psychiatrist before? _
Have you taken psychiatric drugs (antidepressants, antipsychotics, sedatives)? _
What kind of drugs?
_
Have you received a diagnosis / conclusion (psychiatrist, psychotherapist)? _
What are the diagnoses?
Do you give permission for full or partial communication with the indicated doctors? _
Comments and clarifications:
Sleep disturbances (if any)
How well you sleep (1 to 5)
How long do you sleep _
Frequent awakening / inability to sleep _
Early awakening against the will and possibilities _
No deep sleep _
Other _
Appetite disorders
No appetite, no pleasure from food _
Negative emotions in connection with food (guilt, disgust, anger, self-flagellation, etc.) _
Voluntary induction of vomiting _
Involuntary vomiting _
Excessive depletion of oneself by diet _
Protracted periods depression, apathy, guilt, dissatisfaction with oneself, weakness, loss of interest in the joys of life
_
for what period of time _
due to relevant stressors or for no definite reason
Loss of energy / mood in the morning or evening? _
Suicidal thoughts in the past and present:
_
abstract suicidal thoughts or concrete ideas / plan
_
Tendency to aggression and violence
_
drives to militia / police
addiction / history of physical and psychological abuse
_
Violent experience:
_
Physical health and medical problems
_
Endocrine Disorders / Squatting
Neuropathological disorders
Cancer disorders / history
Autoimmune disorders
Chronic disorders
Asthma, chronic bronchitis, breathing disorders
Skin disorders
Allergies
Cardiovascular disorders
Digestive disorders
Addictions (alcoholism / drunkenness, chemical, gambling, etc.)
Family history of these disorders
_
History of suicidality and domestic violence
_
Family history of mental / emotional disorders
_
Distortion of perception
Perhaps you feel something that is not there; see what other, unusual phenomena do not see
Hallucinations
Visions / Sounds / Sensations
_
Psi trauma
Think about the events in your life that influenced you.
To begin with, remember everything that comes to mind, not trying to evaluate with logic, but rather listening to feelings. If the events are remembered, they evoke emotions, but it seems that they did not leave - give yourself time to reflect
On the following table, mark the most significant events (experiences), the memories of which evoke a response, positive with a + sign, unpleasant, respectively -
Put the corresponding number on the age coordinate and find a point on the plane opposite the age corresponding to the intensity of the emotional response (today) from 0 (indifference) to 10 (unbearable)
(loss, illness, experience of achievement, travel, humiliation, meeting and separation)
Below and on the back of the sheet, write how these events changed you, your self-esteem, behavior, increased or weakened some abilities, bodily reactions appeared (for example, a spasm in the throat in the presence of men), habits, bodily and psychological symptoms, etc.
- If memories do not evoke emotions, perhaps you do not so much remember (visualize) them as think about them
- Or, remembering events, you look at the situation from the outside (or from above)
Therefore, remember the events, reviving them in memory, placing yourself exactly there.
Please select symptomfor healing: bodily reaction, emotion, clamps, destructive habit, etc.
Write down
Select an event / symptom with an intensity of emotion (today, at recall) between 4 and 6
name it
revive memories so that emotions come to life and a response curls in the body
In order not to get stuck in unpleasant emotions, breathe all the time, it is better to sigh
Identify and record:
In what situations does it feel stronger (where and with whom) _
What triggers the reaction (the person behind the back, darkness, intonation of the voice, etc.) _
What do you feel in the body (what and what parts) _
Your emotions (fear, anger, powerlessness, shame, etc.) _
Reaction (I want to run, cry, attack, freeze, curl up, swear) _
Breathe and react if needed
Negative thoughts about yourself in connection with this ("it's my fault", "I'm a fool") _
Thoughts about fear of death or loss of control _
Thoughts of resentment and claims (parent, partner, abuser, yourself, God, fate) _
Fatal thoughts (example "I can never be happy again")
Is there a new impulse / reaction (I want to run, cry, attack, freeze) _
Breathe and react if needed
Breathe in slowly, stretched in and out, sigh, yawn
Remember the situation - what is the intensity of emotions now (from 0 to 10)
What would you like to say to yourself there?
-say it
What decision did you make there and then?
What do you accept now, given your strengths and weaknesses and your intention to free yourself?
Your RESOURCES
Internal resources - your STRONG personality traits, skills, talents, habits, etc.
personal qualities:
skill:
talents:
habits:
experience of achievements / success:
External External resources. Family, friends, communities, inspirational books, places, etc.
Your BARRIERS
Subjective (your personal qualities, beliefs and habits, experiences of failure)
Habit save, not enough decisiveness, stubbornness(I'm always right), lone wolf- refusal of help / support, humility, inability say no, Habit controlevents and people, inability or unwillingness to speak "Yes", Inept choice priorities, following minor, Habit not admit the whole truth(silence, errors of thinking)
Other
Objective (Physical limitations, financial, social, etc.) obstacles on the way to your goals
Destructive environments: people, communities, music, movies, multimedia, anything that takes away energy, confidence, self-control, etc.
How do you plan to deal with the described barriers using the above resources
What do you intend to get rid of as a result (fears, habits, beliefs, etc.)
Behavior
Feel
Thoughts
Beliefs
Answer questions in writing.
Allow yourself to think not so much logically as associatively - pay special attention to what comes to mind first.
What am I?
Write down at least five of your positive qualities.
Write at least five qualities that you dislike about yourself
Name those qualities that are peculiar to you, but do not belong to either positive or negative characteristics.
Who am I?
Write at least five definitions without hesitation, the first thing that comes to mind and only after that, after carefully thinking, answer the question with the utmost sincerity and thoughtfulness
In what places and in what environment do you feel real, behave naturally, when you feel comfortable and you feel "at home"
Bring memories back to life so that emotions come to life and the body responds. Your emotions (joy, pride, etc.). What do you feel in the body (what and what parts) _
What occupations, behavior, work give you this feeling, perhaps this feeling that you are really doing what is close to you, inherent in your nature
Bring memories back to life so that emotions come to life and the body responds. Your emotions (joy, pride, etc.). What do you feel in the body (what and what parts) _
What thoughts do you have when you feel this way?
How you should think so that you feel real, behave naturally, and feel "at home"
What pleasant emotions arise with these thoughts. What do you feel in the body (what and what parts) _
What Roles do you consider to be yours, corresponding to your essence, reflecting your essence (Father, leader, troublemaker, etc.)
What pleasant emotions arise with these thoughts. What do you feel in the body (what and what parts) _
What beliefs do you consider to be yours originally, corresponding to your essence, reflecting your essence, worth standing up for them (the main thing in life is …)
What pleasant emotions arise with these thoughts. What do you feel in the body (what and what parts) _
What values do you consider to be yours, corresponding to your essence, reflecting your essence (love, family, money)
Express them in full phrase ("life is worth ….")
What pleasant emotions arise with these thoughts. What do you feel in the body (what and what parts) _
Voice your values and say next: "And it's true!". Do you have any doubts that this is completely true, are there sensations in the body that respond to the phrase "And it's true!" as confirmation.
Who do you really feel, without too much modesty and bragging, write what comes to mind, without thinking:
Complement the phrases spontaneously, without thinking, listening to the sensations in the body, you can use vague metaphors:
- I have always been, am and will be….
- My great gift in this life….
- I came into this life in order to….
- My mission in the world is….
- I will definitely …
Pay special attention to pleasant sensations that reinforce your sense of confidence in your strength and abilities, let your imagination create images. Remember these images and sensations in order to easily enter these states in the future.
Andrew Fleschel
+380 96 8819694, +38 099 770 32 88, +38 093 183 68 12
Clear the rubble, get rid of the trash
Get rid of the old, that which weighs on or stands in the way
Write a list of things to do, relationships of things that weigh you down.
Things:
Affairs
Outdated relationship
Resentment and other feelings that drain your energy
Habits
Limiting beliefs
Experience of failures
Andrew Fleschel
+380 96 8819694, +38 099 770 32 88, +38 093 183 68 12
Questionnaire in MS Word document upon request (contacts above)
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