Occupational Therapy Techniques
Occupational Therapy Techniques
Occupational Therapy Techniques
Trust
Ways to Build Trust
Although we cannot control other people’s behaviour in relationships, we can make sure that we do
everything possible to maintain and strengthen trust in our relationships. Consider the following tips
that can be relevant to healing.
Types of Guilt
Reactive Guilt – Occurs when a person commits an act that, after the fact, strikes them as
unkind or as having had a negative impact. The guilt is a reaction to what they have done.
Anticipatory Guilt – This occurs when a person knows that an act that they are going to
commit, or are considering committing, might have a negative outcome.
Existential Guilt – This occurs when a person struggles with who they are, what they are and
their place in the world. E.g., Someone may feel guilty about being a man because statistics
show that many women are physically harmed by men each year. Even though this man has
never harmed a woman.
Types of Shame
Unrequited love – one sided love is one of the most fundamentally shameful experiences.
E.g., A mother who doesn’t love their child, and the child feels inadequate and lacking.
Desperately want something from someone which they don’t provide so you label yourself as
unworthy/unlovable/not good enough.
Exclusion – think of the time when you weren’t invited to that party or excluded. We need to
belong to our community/herd to keep us alive. Humans on their own in the wild are
extremely vulnerable to predators, just like other mammals. Exclusion is wired into our DNA
to symbolize vulnerability and death.
Unwanted exposure – Being put in situations you don’t feel comfortable in (being put in the
spotlight).
Disappointed reaction – Goals that are unmet.
Regret
Regret can lead to the emotions of guilt and shame.
Regrets are often linked to things we wish we had or had not said.
Unfulfilled dreams.
Expectations not met.
Illness or accidents can prevent us from doing things that could lead to regret.
Why do we dwell?
1. We don’t plan on making as many mistakes as we do.
2. We assume things will turn out okay.
3. We never let go.
4. Mind always returning to ‘might’, ‘could’, ‘should’ and ‘what if’.
Guilt can either hold you back from growing or it can show you
what you need to shift in your life.
The choice is yours.
Attachment Styles
A deep and enduring emotional bond that connects one person to another across time and space.
The first experience we have of a strong emotional bond, is with our mother.
1. Secure attachment
Your caregiver’s behaviour was consistent and caring. They were responsive and sensitive
towards your physical and emotional needs. They were there every time you needed them.
Your childhood taught you: The world is safe: “I can trust other people to help me and to
respond to my physical and emotional needs. I am important enough to be care for”.
Later in life: “I have a secure foundation and a healthy idea of relationships; it is safe to trust
new people. Relationships are a safe place”.
A secure attachment is the ideal, but unfortunately life is not always ideal.
Sometimes things happen to break this attachment/bond between you and your caregiver.
Imagine an apple with a worm inside the apple. These little holes where the worm took a bite
can be seen as attachment breaks.
A few examples of attachment breaks:
o Stressful pregnancy (Unplanned, unwanted conflict during pregnancy).
o Being removed from the caregiver (Adoption, moved to grandparents).
o Early childhood years (Marital stress, financial stress, alcohol use, lost employment).
o Losses (House, loved ones).
o Trauma (Abuse, hospitalization, loss of a loved one).
2. Anxious Attachment
Your caregiver’s behaviour was inconsistent, your caregiver confused their own emotional
needs with your emotional needs. Some days they were extremely caring and in touch with
your needs, other days they were focussed on their own baggage, and they seemed
unavailable.
Your childhood taught you: “Sometimes people respond to my needs and sometimes I feel
ignored. I can’t really always trust people”.
Later in life: “I feel confused and anxious towards people. I have trust issues. People might
leave me easily and won't always be here for me. People are unreliable. I need to show them
that I can’t be without them, or they will leave me”.
3. Avoidant Attachment
Your caregiver did not respond to your needs. They wanted to be independent and strong.
They believed a child should not be “babied” and would encourage you to “grow-up quickly”.
Sometimes they would discipline you or avoid if you seemed “needy” for example saying
things like: “Don’t be such a cry baby”, “I am not going to carry you, you have feet”.
Your childhood taught you: “People don’t respond to your needs at all. I have to take care of
myself. I cannot matter to others. I cannot trust others to help me”.
Later in life: “Why should I even try to have meaningful relationships with my caregiver or
new people if they don’t even really care how I feel. I have to cope with my own. It’s me
against the world”.
Your behaviour in relationships: To a certain degree you avoid intimate attachment, and you
place a lot of focus on independence. Others might feel that you don’t open up towards them
or need them in your life.
4. Disorganised Attachment
Your caregiver was so busy dealing with their own life (either by choice or by
circumstances), they did not recognize or respond to your emotional needs. They may have
treated you poorly due to their own unresolved trauma. Your childhood was a time of intense
stress for you.
Your childhood taught you: “Other people can be really bad and dangerous. They might hurt
my heart and sometimes my body. Approaching them leads to attention, but negative
attention. It probably means I’m not a good person. People will hurt me. I have to be on guard
(fight) protect myself and to get what I need in life”.
Later in life: You are always on guard trying to protect yourself from harm. There are
moments of control and moments of aggression in your behaviour. You come across as
defensive and people are not sure where they stand with you.
Your behaviour in relationships: Your behaviour is confusing, seeing as there are moments of
intimate connection and moments of reacting aggressively. You come across as defensive and
you have poor impulse control during an emotional situation. One moment you want to be
close to someone and the next moment you pull away.
Toxic Relationships
Types of toxic people
Critics.
Irresponsibles.
Borderlines.
Narcassists.
Codependents.
Abandoners.
Dependence
I have trouble tackling new tasks unless I have someone to guide me.
I can’t trust my own judgement and am easily influenced by others’ opinions.
I find everyday life overwhelming and need others to help me cope with everyday tasks.
I am not capable of getting by on my own.
Emotional deprivation
I am often attracted to people who can't meet my needs.
I feel disconnected, even from people who are close to me.
No one is there to give me warmth, holding, affection or is tuned into my true feelings.
It is hard to let people guide/protect me even though it is what I want inside.
Abandonment
I cling to people because I am afraid that they will leave me.
I get desperate when someone I love pulls away.
I worry a lot that people I love will die or leave me.
I need other people too much.
I do not have stable base of support.
Entitlement
I get angry when I cannot get what I want.
I act on impulses and emotions that get me into trouble later.
I insist that people do things my way.
I have trouble accepting ‘no’ for an answer.
Social exclusion
I feel inferior to people around me and think others think less of me.
I feel lonely even when I am with people.
I can’t relax and be myself with people.
I only spend time with immediate family or one/two close friends.
Subjugation
I need to please others/I give more to others than myself.
I feel guilty if I put myself first in relationships.
I go to great lengths to avoid confrontation with others.
Keep a record
Make note of the ways they have let you down or pulled you away from your vision; of all the times
that you have felt less than joyful around this person. This will increase your awareness of how much
someone is taking from you.
We all deserve to have the happiest and fullest life possible. “Show me your friends and I’ll show you
your future”. If you surround yourself with toxic. Dramatic people you’ll have a toxic, dramatic life, if
we surround ourselves with positive, wonderful people, you’ll have a better chance at a positive
wonderful life.
Respect yourself enough to walk away from anything that no longer serves you,
grows you, or makes you happy. And never regret - if it’s good,
it’s wonderful and if it’s bad, its experience.
Patterns of Co-dependency
Relationships are one area in our lives where we feel most vulnerable. All of our deepest fears and
insecurities emerge in relationships. For some there is often a desperate need to be involved, yet for
some a terror of being in a relationship. Co-dependent people either love too much or not at all – or
swing between these two extremes. Not allowing themselves to love at all manifests in a continued
emotional detachment. In this way they never need to worry about being vulnerable or abandoned. If
they do get involved in a relationship, they may be the first to withdraw as soon as they start to feel
too invested and the fear of rejection raises its head. On the other end of the spectrum, and more
common, are those people who, because of their need to be needed, remain intensely loyal and stay in
relationships that are bad for them for much longer than they should. They manage this by losing
themselves in the relationship and making everything all about the other person. They make excuses
for bad behaviour and always look for good in their partner or focus on who they feel their partner
could become rather than who that person really is. They take the little they get and put up with the
scraps. They focus on the needs of their partner at their intuition and ignore the warnings they receive.
Instead, they set about changing themselves into who they think their partner wants them to be,
believing they need to change to better the situation.
Love and work are the cornerstones of our humanness. They are the arenas where we invest most of
our time and energy, and where we give expression to ourselves. Co-dependent behaviour is therefore
also very evident in the workplace. Co-dependents are dream employees, they are so eager to please,
to be seen and loved that they will over extend themselves in all ways. It presents as taking on too
much responsibility, not setting boundaries, not standing up for oneself, not delegating, taking
feedback very personally, focusing on the negatives (unable to see positives in themselves) and
perfectionism.
Being co-dependent is not always a bad thing. Co-dependent people are nurturers, they care a lot and
love a lot too. They want peace and harmony. Where this behaviour becomes a problem is when the
co-dependent has given too much/loved too much. They then become resentful, angry, depressed and
frustrated. They burn themselves out and feel unloved/neglected/abused/taken advantage of by others.
The trick is to learn to understand yourself more and learn how to set some boundaries.
Understanding Co-dependency
Co-dependency is usually a response to trauma
You probably developed co-dependent traits starting in your childhood as a way to deal with an
abusive, chaotic, dysfunctional, or co-dependent family. As a child in an overwhelming situation, you
learned that keeping the peace, taking care of others, denying your feelings, and trying to control
things were ways to survive and cope with a scary and out of control home life. For some people, the
trauma was subtle, almost unnoticeable. Even if your childhood was fairly “normal”, you may have
experienced generational trauma, meaning your parents or close relatives passed some of their trauma
responses down to you.
You can change your co-dependent patterns. People can recover from co-dependency. Change is
a gradual process that requires lots of practice and an openness to try new things and to feel a
little uncomfortable in the process. Co-dependency is not your fault, but you are the only one
who can change it.
Boundaries
“Your personal boundaries protect the inner core of your identity”.
Stop asking why they keep doing it and start asking why you keep allowing it!
Types of Boundaries
Verbal
Verbalising a need: Making our thoughts and feelings known.
Letting others know that you are in control of yourself.
Saying NO.
External pressures (someone pressuring you to do something you do not want to) and internal
pressures (what you ‘should’ do, often unrealistic expectations of yourself).
Physical
Who can be in your space.
Personal space bubble.
Who can touch you, who cannot.
Awareness of what’s appropriate in different settings.
Geographical distance
Removing yourself to replenish physically/emotionally when depleted.
Removing yourself from a situation: Person left behind can feel your absence.
Leaving until the person is ready to deal with the problem.
Mental
Need to be able to say no to self – limits within yourself.
Your opinion vs. another’s opinion: Choosing what you believe of yourself.
Beware of your thoughts and where they may be distorted/assumptions/wrong.
Emotional
Refers to your emotions – when to share and what to share with whom.
Taking responsibility for your feelings (not blaming others).
Not taking responsibility for others’ feelings – is this my feeling or your feeling?
Use emotional distance appropriately.
To keep opening up in an emotionally abusive relationship is self-sabotage.
Material
Refers to money and possessions.
What will you share and with whom?
Time
How do you use your time?
Enough time should be allocated to various facets of life.
Other people
Refers to rescuing others from the consequences of their own actions.
Prevents growth in others.
Allowing others to give to you too – give and take relationships.
Sexual
Refers to emotional, intellectual and physical aspects of sexuality.
Involves mutual understanding and respect of limitations and desires.
Boundaries are a healthy way of protecting the self, they are a set of limits with consequences. These
boundaries can be rigid, porous or healthy.
Rigid Boundaries Porous Boundaries Healthy Boundaries
Avoids intimacy and close Overshares personal Values own opinions.
relationships. information.
Does not compromise values
Unlikely to ask for help. Difficulty saying ‘no’ to the for others.
requests of others.
Has few close relationships. Shares personal information in
Overinvolved with other’s an appropriate way.
Very protective of personal problems.
information. Knows personal wants and
Dependent of the opinions of needs and can communicate
May seem detached even with others. them.
romantic partners.
Accepting of abuse or Accepting when others say
Keeps others at a distance to disrespect. ‘no’ to them.
avoid the possibility of
rejection. Fears rejection if they do not
comply with others.
Most people have a mix of different boundary types. For example, someone could have healthy
boundaries at work, porous boundaries in romantic relationships and a mix of all three types with their
family. One size does not fit all.
The appropriateness of boundaries depends heavily on setting. What’s appropriate to say when you’re
out with friends might not be appropriate when you are at work.
Some cultures have very different expectations when it comes to boundaries. For example, in some
cultures it is considered wildly inappropriate to express emotions publicly. In other cultures,
emotional expression is encouraged.
Change of Taste
You will become drawn to people with healthy boundaries and vice versa.
Healthier Relationships
Clearly defined responsibilities/expectations within relationships result in better relationships.
Treasuring Yourself
By setting healthy boundaries, you give out a message to the world that you love and value yourself.
This will change the dynamic in your relationships as you will no longer be seen as ‘the doormat’.
My Responsibilities
Me.
My feelings.
My behaviours.
My thoughts.
My words.
My burdens (others can support me but cannot fix my problems).
A healthy relationship will never require you to sacrifice your friends, dreams,
values or dignity. Love yourself enough to set boundaries. Your time and
energy are precious. You get to choose how to use them.
Boundary Problems
Complaints – Always saying ‘yes’ when they want to say ‘no’.
Avoidants – Saying no to help: isolating and withdrawing.
Controllers – Not respecting others’ boundaries – either aggressive or manipulative.
Non-respondents – Not hearing the needs of others – feel unsupported or self-absorbed.
Saying ‘NO’
Choice means saying no to one thing so you can say yes to another.
For many of us, we need just to learn to say ‘NO’ as this is a powerful boundary in itself!
Compromise
Being assertive does not mean being dogmatic or stubborn. It may mean helping the other person
reach a decision which is suitable to both parties. E.g., “I’m sorry that I cannot help you today,
however I do have some extra time tomorrow. Would that be okay?”
2. Accepting responsibility
The second apology language, accepting responsibility, occurs when someone earnestly
admits they were wrong to do what they did. Along with acknowledging your fault in the
situation, you name the mistake, so it doesn’t ring hollow. Note that it is easier to say, ‘You
are right’ than ‘I am wrong’, but the latter carries more weight. The person should be able to
explain what they did wrong and why it was wrong.
3. Making restitution
The third apology language, making restitution, includes finding a way to correct the
situation. This is a common apology scenario if something is lost, broken, or damaged and the
apologizer offers to replace the item or pay for the inconvenience. It can also occur in more
serios situations if a person is deeply betrayed and the person who did it makes it up to them.
“What can I do to make it right?”.
4. Genuinely repenting
The fourth apology language, genuinely repenting, requires a change of behaviour. With this
apology language, saying sorry is not enough. There should be a sincere drive to do better, to
problem-solve and come up with a better, more specific plan for change, with no excuses. “I
won't do that again”.
5. Requesting forgiveness
The fifth apology language, requesting forgiveness, allows the other person time to process
their hurt before assuming everything is back to normal. Saying “I’m so sorry for letting you
down. Can you find it in your heart to forgive me?” places the power back into the hands of
the hurt party. While most people won't refuse an apology altogether, it does leave room for
them to make exceptions, including the need for repentance or restitution. “Will you forgive
me?”.
In this model, all six elements are necessary for an effective, meaningful apology – as opposed to in
Chapman’s, which suggests the most people will need only one or two of these elements as their
preferred form of apology.
Another model of reparations stems from the concept of restorative justice or transformative justice,
which are frameworks that focus on restitution and healing instead of punishment for crimes. This
accountability process has gained some popularity in recent years as a way of making amends for
behaviour. In addition to earnestly acknowledging one’s wrongdoing, making repair according to the
wishes of the one who was wronged is key to effective apology (and justice).
Apologizing and becoming more aware is great, but changes in action and physical proof of continued
change and ‘working through’ is what most often helps other people feel that we are sincere in our
apologies. That also means not shying away from others when we mess up (which we will). It means
actively calling ourselves out in those uncomfortable moments and restating our commitments to
change, which is then followed up by visible action.
When to apologize
In general, if you’re questioning whether or not to apologize, you probably should. Finding the right
time depends on the person you’re apologizing to, though. Sometimes they will need things to cool
down, and others like it right away.
Remember, even when it’s difficult, apologizing is the first step toward reconciliation, and
determining someone’s apology language may improve that process.
Quality Time
By ‘quality time’ I mean giving someone your undivided attention, doing things together. I
don’t mean sitting on the couch watching television together. What I mean is sitting on the
couch with the TV off, looking at each other and talking, devices put away, giving each other
your undivided attention. It means taking a walk, just the two of you, or going out to eat and
talking, no distractions.
Time is a precious commodity. We all have multiple demands on our time, yet each of us has
the exact same hours in a day. We can make the most of those hours by committing some of
them to the important people in our lives. If your partner of best friend’s love language is
quality time, they simply want to be with you, to spend time with you.
Receiving Gifts
Almost everything ever written on the subject of love indicates that at the heart of love is the
spirit of gifting. A gift is something you can hold in your hand and say “look, he was thinking
of me”, or “she remembered me”. The gift itself is a symbol of that thought. It doesn’t matter
whether it costs money or not. What is important is that you thought of him or her. And it is
not the thought implanted only in the mind that counts but the thought expressed in actually
securing or making the gift and giving it as an expression of love and care.
But what of the person who says “I’m not a gift giver. I didn’t receive many gifts growing up.
I never learned how to select gifts. It doesn’t come naturally for me”. Congratulations, you’ve
made the first discovery in becoming a great friend, lover or partner. If this is your partner of
friend’s love language, you can learn to become a proficient gift giver. In fact, it’s the easiest
love language to learn.
Acts of Service
Michelle’s primary love language was what I call ‘acts of service’. By acts of service, I mean
doing things your loved one would like you to do. You seek to please by doing things for
him/her. You initiate and put effort into it.
Consider actions such as cooking a meal, changing baby’s nappies, keeping the car in a good
condition, helping to lift kids or picking up mail from the post office – they are all acts of
service. They require thought, planning, time, effort, and energy. If done with a positive spirit,
they are indeed expressions of love. For many, “actions speak louder than words”.
Physical Touch
We have long known that physical touch is a way of communicating emotional love. Numerous
research projects in the area of child development have made that conclusion: Babies who are
held, stroked, and kissed develop a healthier emotional life than those who are left for long
periods of time without physical contact. Physical touch is also a powerful vehicle for
communicating love in adult relationships. Holding hands, hugging, touching a shoulder or arm,
kissing and in some cases sexual intercourse are all ways of communicating emotional love. For
some individuals, physical touch is their primary love language and without it they feel unloved.
With it, their emotional tank is filled, and they feel secure and valued in the relationship. Touches
can be ten times as powerful and comforting as any words!
Stress Management
Anger Management
Anger as a Secondary Emotion
Everyone feels anger at some stage or another – it’s healthy, normal human emotion. It acts as a
trigger to alert us to something that does not feel right. It can arise in many different contexts from
experiencing unjust treatment, hearing criticism or simply not getting what we want. The experience
of anger can range from mild irritation to frustration all the way to a seething rage.
While feeling anger is a natural part of being human, its helpful to think of skilful ways to work with
it that result in healthy living rather than having to live with feelings of regret about what you said or
did.
It is helpful to consider anger as a secondary emotion. It can often feel safer to express our anger than
to express potentially our sadness, hurt, guilt or frustration. Strangely anger can help us feel more in
control and less vulnerable. In these cases, however, our anger clouds the primary emotion which is
actually the feeling we should be working with.
How to Cope with Anger
Consider the STOPP technique as a guideline to managing you anger (or other extreme emotions). It
gives a framework to guide you:
STOPP Technique
Stop
Don’t act immediately. Wait!
Take a Breath
Slowly breathe in and out a couple of times.
Observe
What am I thinking about?
What am I focusing on?
What am I reacting to?
What am I feeling in my body?
Pull Back
Zoom out! See the bigger picture.
Is this fact or opinion?
Is there another way of looking at this?
How important is this situation right now?
Body:
1. Breathing – slow and steady breaths, inhale through your nose and out through your
mouth.
2. Use relaxation tape/app.
3. Gentle rhythmical movement to music.
Behaviour:
1. Move away from others.
2. Put hands by your side or in your pockets.
3. Stretch your body and break the tension.
4. Stretch out your arms, legs and fingers if sitting.
5. Get a cold drink.
6. Exercise – running, walking briskly, punching a punchbag, doing sit-ups.
7. Cushion bashing.
8. Music – listen to uplifting songs.
9. Humour – laugh at yourself or the situation.
10. Scream – not at the other person but in a contained space.
11. Pray/meditate/yoga – find the calm space within yourself.
12. Art – draw, play an instrument, drama, or dance.
13. Writing – reduce stress by writing thoughts/feelings down, create clarity.
14. Find someone to speak to.
2. Once calm, “OBSERVE AND PULL BACK” as you think through the trigger using your wise
mind:
Our wise mind helps us to make sense of our thoughts and feelings, and to come up with a
balanced and wise response, which satisfies our rational thoughts but also soothes our emotional
mind. It therefore reduces our distress and helps make us more effective. Usually quietly calm, its
that wise inner part of us that just ‘knows’ what is true or valid. The wise mind is therefore the
part of our mind where our emotional and reasonable minds merge together.
Emotional Mind Wise Mind Reasonable Mind
Thinking and behaviour Integrates emotion and Intellectual, scientific.
controlled by emotional reason. Logical and rational
state. Adds intuitive knowing to thinking.
Thoughts are unhelpful and emotional distress and Factual thinking, based on
distressing. logical analysis. evidence.
Difficult to think logically The calm that follows a Able to plan how to
and rationally. storm. respond.
Facts are distorted to fit Sees or knows something Focuses attention.
with current distress. directly and clearly. Cool in approaching
Emotion drives opinion. Grasps the bigger picture problems.
Strong emotions drive rather than just parts.
strong behaviour. What is the most effective
skill to use?
3. The helicopter view can also assist you in considering the way forward in dealing with your
trigger:
When something is distressing you, you’re so close to it, involved with it, part of it – it’s really
hard to stand back from what’s happening. You see the close-up view, but you can’t see anything
else. It’s like the well-known saying: “We can’t see the wood for the trees”. If you could zoom
out your view, like a helicopter hovering above, you’d be able to see the bigger picture. You
could stand back, be less emotionally involved, and see a different perspective.
2. Self 3. Others
What am I reacting to? What does this situation mean What would this look like to others involved?
to me?
1. Situation
STOPP!
Take a breath!
What's the bigger picture?
4. Once you have calmed down, you now need to express yourself:
Appreciate that you have a right to your feelings and to your anger. Remind yourself of your
rights to anger so as not to just ignore it and bottle it up. Use these rights to assist in
expressing yourself:
My assertive anger rights:
I have a right to feel angry when I am frustrated.
I have a right to feel angry when I am hurt.
I have a right to feel angry when I am attacked.
I have a right to feel angry when I am oppressed.
I have a right to feel angry when I am exploited.
I have a right to feel angry when I am manipulated.
I have a right to feel angry when I am cheated.
I have a right to feel angry when my needs are ignored.
I have a right a right to feel angry when I am let down.
I have a right to feel angry when I am rejected.
I have a right to feel angry when my health, welfare, happiness, or peace are
threatened.
I have a right to feel angry when my survival is threatened.
I have a right to feel angry when I see other people’s rights being abused or
threatened.
I have a right to feel angry when I see anything which I value being damaged or
abused.
I have a right to feel angry when I lose someone or something which I value.
I have a right to express my anger safely and assertively.
I have a right to choose not to express my anger and to accept responsibility for any
consequences of my choice.
I have a right to encourage others to express their anger safely and assertively.
I have a right to protect myself from the passive or aggressive anger of others.