Fred begins this session by asking Dr. Smelt, “How’s it going, Doc? Did you have a good week?”

“Just fine, Fred. But I’d like to know how your week went.”

“Nothing much happened. Work has been a real bitch though.”

“I remember you work for the city in I.T. What kinds of problems have you been having?” Dr. Smelt queries.

“I’m overloaded with crap. Too many meetings, too many bosses. Morale sucks. What else do you want to know?”

“I guess I’d like to hear more about specific, difficult encounters at work. Give me an example from last week that made you feel upset, angry, or irritated.”

Fred sighs, “Oh, there were so many. Let me think. OK, my direct supervisor asked me to help someone with our new software. It took hours. And that guy coulda’ figured it out just like I did. Anyone would feel angry. But, obviously, I had to do it because he’s my boss. And the guy who couldn’t figure out the software wanted me to spoon feed him. Just outrageous.”

“OK, Fred, that’s good information. How often do things like this happen at work for you?”

Fred responds, “All the time. People constantly come to me asking for help with their problems. Who do they think I am? Their nursemaid? What a bunch of jerks.”

“So,” Dr. Smelt looks up from her notes and says, “It sounds like you don’t think much of your coworkers. How do you think they feel about you?”

“Obviously they don’t respect me because they trample all over my time. But frankly, I don’t much care what they think because they’re pretty much all idiots.”

Dr. Smelt ponders her next move and decides to continue reviewing other issues that lead Fred to feeling angry before trying to actively intervene. “So, let’s go back to the issue of why you’re here. Tell me more about what happened with your wife and why you were sent to see me by the court.”

Fred, looking annoyed, “Listen, doc, like I told the cops, my lawyer, and the judge, and now I’m telling you again—my wife simply fell down the stairs. For God’s sake, I didn’t push her and she backs me up on that. I’m not going to sit here having you accuse me of being physically abusive.”

“I hear what you’re saying, Fred. I’m not here to pass judgment on what happened that day. But I would like to know more about how you and your wife get along in general. Is that OK with you?”

Fred stares at Dr. Smelt intently, “I get along with my wife just fine. Everyone argues sometimes and so do we. Do you have a problem with that?”

“I get the feeling that you’re hearing my questions almost as though they’re accusations, is that right?”

Fred snaps, “Well, aren’t they? They sound that way to me because you’re accusing me of abusing my wife. And the judge obviously thinks that too or he wouldn’t have sent me here.”

Dr. Smelt realizes the need to manage the emotional intensity of the session. She understands that Fred needs to feel heard and believed before she can help him by looking at the numerous distortions in his thinking that lead him to feel angry far more often than he needs to. She says, “So, I’m guessing that you love your wife and that you don’t want to hurt her. You probably feel like you’re a good guy and can’t believe you’re in the situation that you are. Does that capture how you’re thinking?”

Fred’s intensity softens, “Well, actually, yes. You summed it up pretty good. I’m just a regular guy who loves his wife. It feels stunning and unreal that I got sent here. I’m honestly pretty embarrassed about the whole thing.”

Dr. Smelt says, “Thanks for being honest about that, Fred.”

NOTE: Inexperienced therapists often want to intervene the moment they detect distortions in thinking. And Fred’s thinking clearly contains lots of distortions such as personalizing, over generalizing, mind reading, and so on. However, Dr. Smelt will need to gain his trust and cooperation before she will be able to successfully tug him in the direction of change.

Photo Credit: zeek.0910

Anger Management For Dummies

In Therapy Session1.5: Fred
In Therapy Session 2.5: Fred