Running head: MEICHENBAUM: BE AWARE

Meichenbaum: Be Aware
Kortney Sasaki
Azusa Pacific University

MEICHENBAUM: BE AWARE

Constructive Narrative Perspective

Donald Meichenbaum has made a career through his research and strong support
of cognitive behavioral therapy. Meichenbaum is the founder of cognitive behavioral
modification. His work attempts to narrow the gap between semantics and behavior
therapy. He acknowledges the complex development of interaction of language, thought,
and behavior. Meichenbaum believes that speech is an essential component to guiding
behavior. The concept of self-talk can either be functional or dysfunctional to a
persons consequential behaviors. The purpose of cognitive behavioral modification is to
change unwanted behaviors through identifying dysfunctional self-talk. The client is
considered an architect as humans construct their own reality based off meanings they
have created (Meichenbaum, 1993).
This therapy approach, constructive narrative perspective, emphasizes the
importance of the clients stories and the goal is help change the stories to be more
adaptive.
According to Meichenbaum (1993) Moreover, these cognitive errors were
viewed as being a consequence of the cognitive structures or beliefs, schemata,
current concerns, and tacit assumptions that clients brought to the situations. It
was proposed that such beliefs were strengthened by the manner in which clients
behaved (p. 202).
The clients way of telling stories about distressing situations is critical because it is
internalized from their perspective. The stories the client tells himself or herself has an
affect on consequential behavior. In other words, the self-verbalizations lead to
behavioral outcomes. The client will learn new coping skills in order to facilitate altering

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stories into a more adaptive and helpful manner. It is also helpful for the therapist to hold
the client responsible for the changes they make in their life, supporting their progression
through the process.
The therapy process entails three phases for the client to work through. The first
phase is self-observation. According to Meichenbaum (1994) The first goal of therapy is
to have the patient entertain the possibility that his maladaptive behaviors and emotional
upset are contributed to by what he says to himself (p. 189). The client must listen to
himself or herself as they observe their behavior in combination with self-talk. The focus
of self-talk is centered on recognizing negative statements and altering those beliefs.
Phase two is the clients efforts to change their self-talk to a more adaptive approach and
positive internal dialogue. The client will start to notice patterns of negative thoughts,
which will be the area of acquired change. Instead of avoiding negative self- statements,
the client copes through positive self-verbalizations. For example, instead of saying
something is too difficult to complete, the client will acknowledge the level of difficulty,
but will not state that it is a definite failure. Phase three recognizes the clients new skills
of cognitive restructuring, specifically negative self-statements. Meichenbaum (1993)
describes the last phase as The therapist helps clients to cognitively reframe events and
to normalize their reactions (p. 203). Through positive self-verbalizations, the
following behaviors to the speech will be positive based on the new skills learned. The
therapist is there to help reform narratives to create new stories. The new narratives that
a client creates will incorporate into a whole new life narrative, which is the summation
of key events that the client has turned into meaningful stories.
Root Metaphor

MEICHENBAUM: BE AWARE

A recurring theme in Meichenbaums constructive narrative perspective is the need for

awareness. Human beings have the ability to have control over their behaviors through
self-awareness. The awareness needs to focus on self-verbalizations and related thoughts
and feelings.
Meichenbaum (1977) touches on the need for awareness by stating, An implicit
assumption in most of the studies to be reviewed is that a persons cognitions are
instances of automatic thoughts that are part of a maladaptive response chain.
Given this assumption, the first task of therapy is to have the client become aware
of the role such thoughts play in a sequence of behaviors.
In order to change the maladaptive behaviors, the thoughts of a client must be interrupted
before the maladaptive response occurs, and instead the client must generate opposing
instructions for themselves. Meichenbaum (1977) found Individuals do not merely
respond to events in and of themselves, but respond to their interpretation of events and
to their assigned perceived implications of these event (p. 103). The acknowledgment of
ones own thoughts and response is key because the importance does not lie in the actual
event, but what the person says to themselves about the event, which influences his or her
behavior. This will bring forth progression of therapy by the therapist teaching the client
how to think and respond.
Meichenbaum (1977) describes his perspective My own approach is closer to
that of Beck than to Ellis, as I attempt to have my clients increase their awareness
of the negative self-statements and images they emit but without formally doing a
rational analysis of the so-called irrational belief system (p.198).

MEICHENBAUM: BE AWARE

Practicing awareness helps the client to identify their own distorted reality,
misconceptions, and maladaptive behaviors by testing their validity and sensibleness.
The Self
Meichenbaum views humans as capable and adaptive beings. Humans have the
capacity to change their cognition, emotions, and behaviors. As a cognitive therapist,
Meichenbaum holds the belief that distressing emotions can result in maladaptive
behaviors. Humans also have the innate desire to eliminate distress and therefore,
cognitive interventions are needed. Within the constructive narrative perspective, selftalk is important to recognize as an action that produces feelings within a person, then
maladaptive behaviors. The concept to acknowledge is that humans are self-sustaining
through self-talking and self-evaluation. The targeted area to change behavior comes
from self-verbalizing. Meichenbaum (1977) In other words, early in the mastery of a
voluntary act speech serves a useful supportive and guiding function. With practice the
verbalizations disappear (p. 19). External speech develops into the skill of internal
speech, which internalizes thoughts of oneself, and then consequential behavior. The
beginning production of distress resonates within humans; therefore humans must act to
change themselves. Self-control is another aspect that is related to awareness as a person
is trying to change behavior. The self is contained within the self. A person is defined by
their actions because they are capable of change if they desire to do so.
Meichenbam (1977) One of the underlying principles behind the many treatment
suggestions offered is that by inhibiting an impulse at a low level of intensity or at
an incipient state and then practicing self-control or inhibition at increasingly
greater levels of intensity the impulsive client will develop self-control (p. 104).

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A person can control the automatic behaviors from impulses, once awareness of the
events and responses are recognized. According to Meichenbaum (1994) One task for
the therapist is to help clients appreciate how they construct reality, how they live the
stories they tell, and how they can begin to change their stories, and their behaviors (p.
110). Clients have the capacity to change because they are the creators of their narratives,
stories, to begin with. The power to change resides in the client, as the self is selfsustaining.
View of Transcendence
Meichenbaum did not believe that the self and religion are incorporated within
one another. Religion provides coping mechanisms and hope during difficult times.
According to Meichenbaum (1994) Religion and rituals provide a powerfully culturally
accepted metaphors and a framework to construct a new adaptive narrative (p.545).
Although religion is not a key component in the constructive narrative perspective, the
idea of self-transcendence is somewhat related. Meichenbaum respects that clients may
feel that they are a part of the universe and have spiritual experiences. Spirituality is
considered a facet of personality, but it is only a concept that affects behavior when
considering its relation to constructive narrative perspective. People may have strong
beliefs in spirituality and religion, but in the constructive narrative perspective, it is not a
sense of being for the self. The source of meaning for the self lies within behavior,
behavior that is affected by feelings, language, thoughts, and spirituality or religion.
Normative Framework: Frankena
In considering Meichenbaums background in cognitive behavioral therapy,
specifically the constructive narrative perspective, he thinks the desirable standards of

MEICHENBAUM: BE AWARE

conduct and character traits are formed through behaviors. Within normative ethics,
constructive narrative perspective would fall under Obligation Theory. Obligation Theory
is defined by actions of right and wrong in comparison to Value Theory, which
emphasizes a persons character. For constructive narrative perspective, the person must
change their maladaptive behaviors in order to promote himself or herself in a manner
that then benefits their external world. According to Meichenbaum (1977) therapy is a
learning process through which a person acquires an ability to speak to himself in
appropriate ways so as to control his own conduct (p. 185). The moral obligations that a
person holds are to the result of the actions, the ends. Teleology emphasizes the ends,
results of actions. Frankena (1973) defines Teleological theory as saying, the basic or
ultimate criterion or standard or what is morally right, wrong, obligatory, etc., is the
nonmoral value that is brought into being (Egoist and Deontological Theories, para. 6).
The moral quality of a person resides within the nonmoral value that he or she brings
about. The nonmoral value within the constructive narrative perspective would be related
to control, with self-control the person benefits themselves and those surrounding them.
Within Teleological theories, constructive narrative perspective would fit under the
definition of ethical egoism, non-hedonistic. According to Frankena (1973) Ethical
egoism is an ethical theory, not a pattern of actions or trait of character, and is compatible
with being self-effacing and unselfish in practice (Egoist and Deontological Theories,
para. 17). An ethical egoist does not necessarily mean they are narcissistic or behave
selfishly.

The clients of this therapy approach work on themselves, which appears

selfish, but their adaptive stories lead to well-being, which benefits society as a whole
with normalized persons.

MEICHENBAUM: BE AWARE

Implications of Normative Framework

This complete normative framework implicates that the constructive narrative
perspective client is in control of their own outcomes through speech and more
importantly, behaviors. The clinical population goes to therapy to recognize their self-talk
and act accordingly. According to Meichenbaum (1977) Nonclinical populations may
also hold many of the unreasonable premises that characterize clinical populations. But
what the nonclinical subjects says to themselves about irrational beliefs, the coping
mechanisms they employ, may be what distinguishes clinical from nonclinical
populations (p.191).

The therapist must acknowledge the difference between their

clients and the nonclinical population in order to provide assignments to encourage better
coping mechanisms, rational self-talk, and therefore adaptive behaviors. The constructive
narrative perspective requires the therapist to guide the client to awareness of thoughts,
feelings, and patterns of behaviors in differing situations. According to Meichenbaum
(1994) Common to each of these proponents is the tenet that the human mind is a
product of the personal meanings that individuals create (p. 103). The client is the
creator of their life and the meanings they form are part of natural processing through
cognition. The client is held responsible for their actions, which in turn affects any
clinical outcomes. Meichenbaum (1994) states, In summary, psychotherapy is viewed as
a means of helping clients construct a new narrative (p. 111). Through therapy, the
therapists role is to help the clients create new stories, which changes consequential
behaviors because of their new thoughts and feelings. As a whole, this therapy approach
takes a hands-on strategy, working with the client, to change their behavior, therefore
change their life.

MEICHENBAUM: BE AWARE

Interactional Nature of Consciousness

The consciousness of a person through the constructive narrative perspective
considers mental and physical components. Meichenbaum considers control a value
within humans and believes in the capacity to change. Humans have the capabilities to
control their life through their behaviors, but their thoughts and feelings must be
considered. Meichenbaum (1994) states In short, the gatekeeper has to notice, catch,
interrupt, plan, make choices, and engage in many other executive self-regulatory
activities that are at the heart of cognitive behavioral interventions (p.110). Through
their own consciousness and awareness, humans must make the effort to change their
maladaptive thinking and behaviors, through control and self-regulation. The power of
change lies within the people themselves as they work with their own consciousness.
Role of Religion or Faith in Development
Recognition of the influence of religiosity and spirituality is made in
Meichenbaums process of therapy. The consideration of the American population results
in a society that is very religious and faith-based. It is important to know the difference
between religiosity and spirituality. Meichenbaum (2008) defines spirituality as an
attempt to seek meaning, purpose and direction of life in relation to a higher power,
universal spirit or God. (pg.5) Spirituality is more so a feeling of hope to those that cope
with it. According to Meichenbaum (2008) religion refers to a form of social institution
with its accompanying beliefs, practices, symbols and rituals (p.5) Religion is a more
formal structure in comparison to spirituality because it provides a final meaning to life.
The use of terms religion or spirituality must be recognized as different entities for
individuals. Meichenbaum states Religion can play a significant role in helping people

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cope with stress or to protect against stress (p.6). Whether religion or spirituality, these
concepts are used as coping methods and Meichenbaum accepts that people choose to
believe or to not and it is a part of their identities and stories. Although religiosity and
spirituality are not essential components to the constructive narrative perspective,
Meichenbaum respects that humans can make those concepts a part of their narratives
and it is important to gain more information about how it affects humans lives. When
conducting spiritual assessments it is important to be respectful and supportive of any
beliefs as it may be a part of the development of a person.
Meta- Ethics
The foundation of ethics, meta-ethics, for constructive narrative perspective is
supported by Definist Theories. According to Frankena (1973) This is the definist view
that Ought can be defined in terms of Is, and Value in terms of Fact (Meaning and
Justification, para.8). The constructive narrative perspective falls under the category of
cognitive behavioral therapy, which emphasizes behaviors and actions as definers of a
person. The ought in definist theories are the behaviors and the consequential reaction
and affect from the behavior determines the values. Constructive narrative therapy
focuses on behaviors, which act as the empirical facts because in the natural world, there
is value in how one behaves with another. The nature of the person determines the good
within them.
Clinical Outcomes
The purpose of constructive narrative perspective is to help clients recognize
negative precursor self-talk, feelings, and thoughts in order to change consequential
behaviors.

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According to Meichenbaum (1977) Whereas the Ellis and Beck cognitive

therapy approaches sensitize the therapist to listen for the presence of maladaptive
self-statements, assumptions and beliefs, the cognitive therapist with a problemsolving and coping-skills orientation listens for the absence of specific, adaptive,
cognitive skills and responses (p.194).
With the combination of both cognitive therapy approaches, the constructive narrative
perspective aims to provide the tools of adaptive behavior responses, which in turn better
the person internally. When a person is not suffering internally from anxiety, distress,
trauma, etc., the person may act adaptively and have a better sense of well-being.
Through the therapy process, the clients will reach the clinical outcome of awareness
within themselves.
The process of therapy includes restructuring cognitions and also the language
used to describe life events. Meichenbaum (1977) describes Cognitive restructuring
therapy and semantic therapy are generic terms that refer to a variety of therapeutic
approaches whose major mode of action is modifying the patients thinking and the
premises, assumptions, and attitudes underlying his cognitions (p. 183-184). This
implies that the work of the therapist is to familiarize themselves with how the client
thinks, their feelings, and behaviors to understand how they behave with others.
The combination of language and behavior in constructive narrative perspective
takes into account multiple facets to provide therapy to clients to help improve their lives.
The aim to provide a complete therapeutic approach to relieve life stressors and anxiety
appears to be accomplished by this approach. Constructive narrative perspective would
work on a population that wants guidance in order to change their life; it is a more hands-

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on approach with tasks and assignments. An improvement in this perspective would be

adding a moral sense to the behaviors, rather than behaviors that are solely adaptive and
normalized. With religion also being a non-emphasized factor, it seems essential to have
a spiritual aspect to behaviors for the population that has strong ties to a higher being or
specific denomination.
Development of Moral/Spiritual Self
The development of a moral or spiritual self within the constructive narrative
perspective is not a key component of this therapy approach. The faith in this therapy
approach is within human kind and their interactions with others. The nature of human
beings is essential, spirituality and morals are not. Although morality and spirituality are
not key components, constructive narrative perspective acknowledges and respects those
concepts, as it is a part of peoples identities at times. According to Meichenbaum (1994)
The research on stress coping and religion suggests that clinicians should ask clients
about their religious, philosophical, or world view (p. 547). Therefore, this therapy
approach does not further develop the self according to morality or spirituality, but does
accept that it can be used to further hope and coping within a person.

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References

Meichenbaum, D. (1994). A clinical handbook/practical therapist manual: For assessing

and treating adults with post-traumatic stress disorder (PTSD). Waterloo, Ont.,
Canada: Institute Press :.
Meichenbaum, D. (1993). Changing Conceptions of Cognitive Behavior Modification:
Retrospect and Prospect. Journal of Consulting and Clinical Psychology, 61(2),
202-204.
Meichenbaum, D. (1977). Cognitive-behavior modification: An integrative approach.
New York: Plenum Press.
Meichenbaum, D. "Trauma, spirituality and recovery: Toward a spiritually integrated
psychotherapy." Unpublished paper, The Melissa Institute for Violence
Prevention and Treatment, Miami, Florida (2008).