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Section 2
Cognitive Restructuring with Self-Critical Perfectionism

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In the last section, we discussed a guide to assessment. This guide covered five areas of assessment. These five areas are pathological practices, ownership of self-critical behaviors, the client’s purposes, problematic situations, and historical influences. 

In this section, we will discuss cognitive restructuring to raise self esteem. Three Cognitive Behavior Therapy methods for cognitive restructuring for self esteem are self reproach evaluations, personifying the critic, and introducing the healthy voice. I find that the best place to begin is with the client’s thoughts.

3 CBT Methods for Cognitive Restructuring for Self Esteem  

♦ Method #1:  Self Reproach Evaluations
First, you might consider asking your client to do a Self Reproach Evaluation.  For example, I asked Chad what he was thinking during a recent episode of self reproach.  Chad, age 34, stated, "Well, I was blaming myself for everything that was going wrong and comparing myself to everybody at work.  They all seem to have their lives together so much better than I do." 

With your client, like Chad, you can get as much detail as you can about the critical self talk and then introduce the concept of the pathological critic.  We’ll discuss the pathological critic and how to disarm the critic in more detail in later sections.  First, however, would you agree that evaluating your client’s degree and method of self reproach can be a productive way to begin cognitive restructuring for self esteem?

♦ Method #2:  Personifying the Critic
Next, let’s discuss personifying the critic. You might encourage your client to personify his or her pathological critic. By doing so, I find that the client may begin to hear the voice of self reproach coming from the outside rather than the inside. I encouraged Chad to develop a unique name for his pathological critic. Would you agree that developing a name for the critic could serve clients like Chad as a way to begin to take ownership of the concept of dysotonic personal criticism? 

Chad named his pathological critic ‘the shark,’ because Chad felt the critic was underhanded. In later sessions with Chad, he seemed to feel that it was easier to fight against self reproach once he perceived it as something external. I find that with clients like Chad, the belief that the voice of criticism is not the client’s own can be productive.  In short, cognitive restructuring for self esteem becomes easier when the therapist makes the critical voice ego dysotonic, or something the client eventually rejects as ‘not me.’

♦ Method #3:  Introducing the Healthy Voice
At the same time you are identifying and naming the pathological critic, you can also introduce the client to his or her healthy voice.  The healthy voice is the client’s ability to think realistically.  By emphasizing and strengthening this ability you are positioning the client to begin talking back to the critic. Chad referred to his healthy voice as ‘my rational part.’  Your client may also benefit from choosing a name that fits the client’s self concept, such as rational, compassionate, or objective. 

Would you agree that by creating this dichotomy between the critical voice and the healthy voice, you can encourage clients to confront the critic.  For example, I asked Chad about a new friend that he had made.  I asked, "So what did the critic say when you waited and didn’t hear from your new friend?"  Chad responded, "That I’m not interesting, that I bored him and he was tired of me."  I then asked Chad what the healthy coach said back.  Chad stated, "That our conversation was lively and fun.  That there was nice energy between us.  I could also call my friend and try to get a sense of how he feels." 

In this section, we have discussed CBT methods for cognitive restructuring for self esteem.  Three methods we discussed were self reproach evaluations, personifying the critic, and introducing the healthy voice.

- Walbrugh, V. (Jul 2016) How to Deal with Low Self-Esteem: A CBT-Based Plan for Overcoming Thoughts and Eliminating Self-Doubt. Educational Psychology in Practice, 32(3), 324-324.

In the next section, we will discuss the pathological critic.  I find that these critics begin with an arsenal of shoulds which can be linked to five determining factors of the strength of the self critic.  These five factors are the degree to which issues of taste, personal needs, safety, or good judgment were mislabeled as moral imperatives, the degree to which parents failed to differentiate between behavior and identity, the frequency of the forbidding gestures, the consistency of forbidding gestures, and the frequency with which forbidding gestures were tied to parental anger or withdrawal.
Reviewed 2023

Peer-Reviewed Journal Article References:
Dunkley, D. M., Starrs, C. J., Gouveia, L., & Moroz, M. (Feb 10 , 2020). Self-critical perfectionism and lower daily perceived control predict depressive and anxious symptoms over four years. Journal of Counseling Psychology, No Pagination Specified.

Kopala-Sibley, D. C., Klein, D. N., Perlman, G., & Kotov, R. (2017). Self-criticism and dependency in female adolescents: Prediction of first onsets and disentangling the relationships between personality, stressful life events, and internalizing psychopathology. Journal of Abnormal Psychology, 126(8), 1029–1043.

McGrath, D. S., Sherry, S. B., Stewart, S. H., Mushquash, A. R., Allen, S. L., Nealis, Logan J., & Sherry, D. L. (Jul 2012). Reciprocal relations between self-critical perfectionism and depressive symptoms: Evidence from a short-term, four-wave longitudinal study. Canadian Journal of Behavioural Science, 44(3), 169-181.

Niileksela, C. R., Ghosh, A., & Janis, R. A. (2021). Dynamic changes in generalized anxiety and depression during counseling. Journal of Counseling Psychology, 68(1), 112–124.

“Self-critical perfectionism and depressive and anxious symptoms over 4 years: The mediating role of daily stress reactivity”: Correction to Mandel et al. (2015) (2017). Journal of Counseling Psychology, 64(2), 232.

Shikatani, B., Fredborg, B. K., Cassin, S. E., Kuo, Janice R., & Antony, M. M. (Apr 2019). Acceptability and perceived helpfulness of single session mindfulness and cognitive restructuring strategies in individuals with social anxiety disorder: A pilot study. Canadian Journal of Behavioural Science, 51(2), 83-89.

Shurick, A. A., Hamilton, J. R., Harris, L. T., Roy, A. K., Gross, J. J., & Phelps, E. A. (Dec 2012). Durable effects of cognitive restructuring on conditioned fear. Emotion, 12(6), 1393-1397.

What are three CBT methods for cognitiv
e restructuring for self esteem? To select and enter your answer go to Test.

Section 3
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