The patient practices healthy behaviors in therapy sessions, using both imagery and role-playing. The patient runs through imagery rehearsals of the problematic situation and role-plays the situation with the therapist. The patient visualizes managing the situation in imagery, successfully navigating potential stumbling blocks. Following is an imagery scene with Justine.
THERAPIST: Close your eyes and get an image of Richard coming home. He’s late and the baby’s crying and you’re at the end of your rope. Can you see it?
JUSTINE: (with eyes closed) Yes.
THERAPIST: What’s happening?
JUSTINE: I’m waiting for him, walking around, watching the clock.
THERAPIST: What are you feeling?
JUSTINE: One minute I’m feeling scared to death that he’s never coming home, the next minute I want to kill him for doing this to me.
THERAPIST: What happens when he walks in the door?
JUSTINE: He gives me this look, questioning, to see what kind of mood I’m in.
THERAPIST: What do you want to do?
JUSTINE: I don’t know if I want to scream at him and beat his chest with my fists, or run up to him and hug him.
THERAPIST: How do you handle the two parts?
JUSTINE: Well, I talk to the angry part. I tell her, “Listen, you love Richard, and you don’t want to hurt him. You’re just upset because you thought he wasn’t coming home anymore, but here he is! You can be happy.”
THERAPIST: And what does the angry part say back?
JUSTINE: She says, “OK.” She feels OK.
In talking to her angry side, Justine is doing mode work. She is conducting a dialogue between the Angry Child and the Healthy Adult modes.
In role-plays, the therapist typically models the healthy behavior first, with the patient playing the other person in the problematic situation. Then the therapist and patient switch roles, with the patient practicing the healthy behavior, while the therapist plays the other role. The therapist and patient work through the most likely stumbling blocks so that the patient feels well prepared.