“I would just like to thank you for your amazing content and online courses. Thanks to your help I am no longer homebound by crippling panic and anxiety. I went out today into a busy town and was happy, I feel safe and liberated. I have shared all my progress with my doctor and she is ecstatic about my progress and will be recommending your courses to other patients struggling with mental health. I am medication free and happy for the first time in my life. The changes are long lasting and I now can get myself out of a low without going further down the rabbit hole.”
The idea of repressed memories goes all the way back to Freud, through the 90’s when therapists accidentally implanted people with false memories, through the courtrooms, and into today where the idea of repressed memories is still popular among lay people and controversial among therapists and researchers. So today you’ll learn three skills for better understanding lost memories, aka dissociative amnesia or repressed memories (or at least my opinion about it). The idea of repressed memories goes all the way back to Freud, one of his first patients, Anna O had all sorts of unexplained physical symptoms, when she began talking with her doctor about her life, previously forgotten memories of trauma came back and as she talked about them, her physical symptoms went away. Freud developed the concept of repression, that current symptoms are all related to something that happened in the past, that we repress the memories to protect ourselves, and that we must analyze our psyche in order to uncover it, integrate it and then be freed from it. So that’s where the whole process of psychoanalysis came from, the idea of patients laying on a couch, talking about their childhood. But this concept of repressed memories has become very controversial, because of the way memory works. Most people assume that memory is like a video, your memory records things as they actually happened and stores those memories away, permanently. But memory doesn’t work like that, memories are highly influenced by our biases and how we’re feeling during or after an event. Even Freud learned that many of the things that his patients “remembered” weren’t actual events. Memories can be altered, implanted, influenced, and straight up created under suggestion. Lot’s of laboratory experiments have demonstrated that our memories are terribly fickle.
If you want to see for yourself how this can work, watch this YouTube video “Take This Test and Experience How False Memories Are Made”. https://www.youtube.com/watch?v=D5sk504Yc94
After I filmed this video on repressed memories and dissociative amnesia, the NYT published a very relevant article and two strong opinions on it: https://www.nytimes.com/2022/09/27/opinion/recovered-memory-therapy-mental-health.html
https://www.nytimes.com/2022/10/29/opinion/letters/mental-health.html
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Therapy in a Nutshell and the information provided by Emma McAdam are solely intended for informational and entertainment purposes and are not a substitute for advice, diagnosis, or treatment regarding medical or mental health conditions. Although Emma McAdam is a licensed marriage and family therapist, the views expressed on this site or any related content should not be taken for medical or psychiatric advice. Always consult your physician before making any decisions related to your physical or mental health. In therapy I use a combination of Acceptance and Commitment Therapy, Systems Theory, positive psychology, and a bio-psycho-social approach to treating mental illness and other challenges we all face in life. The ideas from my videos are frequently adapted from multiple sources. Many of them come from Acceptance and Commitment Therapy, especially the work of Steven Hayes, Jason Luoma, and Russ Harris. The sections on stress and the mind-body connection derive from the work of Stephen Porges (
Self-therapy refers broadly to the idea of treating one’s own emotional or psychological problems, without the assistance of a therapist.
But what does it really mean?
In this article, we look at the difference between self-therapy and closely related themes, such as self-counseling and self-help.
Throughout, we will consider how self-therapy can comprise a significantly powerful tool in handling anxiety and depression, and how you can tap into what we already know about the idea to help yourself and others.
Before you read on, we thought you might like to download our 3 Positive Psychology Exercises for free. These science-based exercises will explore fundamental aspects of positive psychology, including strengths, values and self-compassion, and will give you the tools to enhance your wellbeing.
What is Self-Therapy?
Just as there is a wide range of different types of psychotherapy, self-therapy can have a lot of different definitions. Generally, the term refers to psychotherapy we can conduct, on ourselves, without the intervention or assistance of a therapist (King et al., 2017).
Let’s look at different terms that get used interchangeably with ‘self-therapy.’
Self-Therapy, Self-Counseling, and Self Help Therapy. Is It the Same Thing?
Self-therapy, self help therapy and self-counseling sound a lot like the same thing.
And to be honest, different practitioners (and individuals) may choose to use the terms the same or in different ways. If that sounds confusing, it is because there are no strict rules around our chosen use of the different terms.
Self-Therapy vs Self-Counseling
According to The Counsellor’s Guide, self-counseling refers to the practice of:
“Examining one’s own behavior, using psychoanalytical methods of free-thinking and free association”. It can “help you take more effective control of everyday situations, and enable you to make continued progress”.
Self-counseling approaches can include applying techniques such as Glasser’s Reality Theory (RT), Gestalt Therapy, and Ellis’ Rational-Emotive Therapy (RET), as well as tools like meditation, relaxation, and more (Makuch, 2014; Martin, 2014).
Merriam Webster defines self-therapy, on the other hand, as follows:
“Therapeutic treatment of oneself especially for the purpose of coping with one’s personal or emotional problems”.
While both involve introspection to some degree or another, therefore, the difference may lie essentially in what distinguishes therapy from counseling. WebMD (WebMD, 2018) sums this up nicely:
“Counseling is also usually more short-term than therapy. Psychotherapy is more long-term than counseling and focuses on a broader range of issues.”
Self-Therapy vs Self Help Therapy
There is a significant overlap between self-therapy and self-help therapy. That’s because both terms describe self-driven methods of treating psychological problems or growing our internal capabilities. ‘Self help therapy’ implies that a specific problem is being addressed, though there’s no strict definition of it. ‘Self-therapy’ encompasses growing our capabilities.
Another thing you may notice is that ‘self-help therapy’ and ‘self-therapy’ are very often used to describe Cognitive Behavioral Therapy (CBT). It’s worth noting that, while both can involve CBT to some degree or another, it’s more common in mainstream media to see CBT being linked more explicitly with the former (Anxiety Canada, 2018; NHS Inform, 2018).
In short, both are almost the same, and neither is linked exclusively to CBT. As we’ll see, self-therapy can be used to describe many different techniques.
Can You Do Self-Therapy and Does it Work?
Self-therapy is absolutely something that you can practice on your own to work on anxiety or depression; without needing to become accredited or attain a formal qualification. In fact, it can be an economical and more practical solution for less serious cases.
Therapists aren’t on call 24/7, and learning to do self-therapy can be a brilliant resource for those times when you or your client might experience strong feelings of anxiety or depression.
7 Tips on How to Do Self-Therapy
Because there are so many ways of going about self-therapy – from CBT to Rational Emotive Behavior Therapy (REBT) and more, there are many tips out there on how best to go about doing self-therapy.
Here, we’ve isolated some of the key things that contribute to better results over the long term (Knaus, 2014; Therapist Aid, 2018; Weiss, 2018).
1. Start by thinking about what you’d like to achieve.
Are you hoping to learn techniques for managing anxiety? Looking to nip negative thoughts in the bud? Do you want to work on developing some positive current behaviors? There’s no ‘right’ answer. Clarifying your overarching goal will make your different objectives easier to understand.
2. Understand more about your problem or goal.
Knaus (2014) outlines how REBT involves separating your ‘problem’ into a practical part and an emotional or behavioral part. Weiss (2018) suggests learning more about the different ‘sub-personalities’ of your psyche that are causing you problems. CBT exercises recommend identifying your triggers and cognitive distortions.
All these have one thing in common. To work towards your goal, you need to develop your understanding of your problem. This article contains worksheets, questions, and links to resources that may be helpful starting points.
3. Study your feelings and/or behaviors more closely.
Take a closer look at how your problem is presenting. Are you hoping to address a behavioral problem, like avoidance or coping behaviors? Or are you wanting to target unwanted feelings, like social anxiety or stress?
Studying your behaviors or emotions at a more in-depth level can involve:
- Describing the feeling or behavior: what were you thinking, how intense was the feeling, and did you feel anything else?;
- Recalling times that you felt or acted a certain way. Try to take an objective approach to recount where you were, who was there, and alternative actions or feelings you might have experienced;
- Keeping a record of when and where these feelings or behaviors pop up. Are you able to discern any patterns? Are there certain situations that lead to the problem?
4. Identify and explore any associated self-talk, thoughts, or beliefs.
Very often, irrational or unhelpful cognitive mental processes are behind unwanted feelings and behaviors. Stress, anxiety, depression, and even relationship difficulties can often be addressed by identifying the negative self-talk or distortions that go on in our head.
Feel free to pick and mix any of the questions we’ve provided in the next sections to guide you through this step.
5. Challenge your irrational thoughts, internal dialogue, or beliefs.
We’ve also included a whole range of worksheets and resources to help you with this step. Regardless of which direction you choose to take your self-therapy, the goal is to feel more positive. We can do this much more effectively by addressing the root cause of the problem, which a lot of medications don’t do.
6. Replace your irrational thoughts or beliefs.
As an example, Sarah is given feedback on a work task by her boss. Instead of allowing herself to think negatively (e.g. “I’m not good enough”), she replaces this with a more objective, rational thought.
Instead, she thinks: “My boss sees my full potential, and I’m excited to grow and realize that potential”.
7. Practice, practice, and practice.
Every day, we face triggers and external events that we have no control over. As we practice, develop, and strengthen our rational and positive thought processes, we get better at managing our responses to them.
Reward yourself with something you enjoy doing for keeping up the good work.
21 Excellent Self-Therapy Questions
Self-therapy questions are designed for you to ask yourself. The aim of self-therapy questions is to probe a little deeper into the nature of whatever anxiety, depression, or emotional problems you might be experiencing.
These questions require nothing more than something to write with, but keeping your answers on hand can be very helpful over the long term. You or your patients may find that being as honest as possible while answering makes for more powerful reflection at later points in time.
The Cycle of Anxiety Worksheet and Questions
This worksheet and set of questions are best used together. The Cycle of Anxiety worksheet helps those of us with anxiety understand how the symptoms often lead us to engage in avoidance behaviors. Because many therapeutic interventions (such as CBT) attempt to deal with anxiety by ‘breaking the cycle’, the illustration can be helpful to visualize, understand, and target the source of our anxiety.
As part of self-therapy, you can use the Cycle illustration to introduce yourself or your client to the concept of how feedback and reinforcement contribute to the recurrence of avoidance behaviors.
This activity can help facilitate an understanding of why it’s often important to tackle the source of these negative emotions head-on when they occur. As a therapist, it is often not possible to be around when your client experiences external anxiety-inducing triggers, and this worksheet is very handy for them to have on hand.
The questions accompanying the worksheet help you or your client make the Cycle more meaningful, and include the following:
- What are three things that trigger your anxiety?
- What are three physical symptoms that you experience when you feel anxious?
- What are three thoughts you tend to have when you feel anxious?
- What are three things you do to cope when you are anxious?
By asking yourself these questions, you can develop a better sense of what triggers your anxiety, how it manifests physically and mentally, and the avoidance behaviors you commonly exhibit.
You can access and download The Cycle of Anxiety Worksheet from TherapistAid, and the full set of questions.
Self-Therapy Questions for Challenging Negative Thoughts
Anxiety and depression often come together, being brought about by negative thought processes. These questions are designed to help you or someone you know to challenge these maladaptive thoughts and help you reassess them. Ideally, they should provide an alternative perspective and help you cope with or reframe the situation.
- Is there substantial evidence for my thought?
- Is there evidence contrary to my thought?
- Am I attempting to interpret this situation without all the evidence?
- What would a friend think about this situation?
- If I look at the situation positively, how is it different?
- Will this matter a year from now? How about five years from now?
Challenging our subjective or potentially distorted thinking patterns is a logical next step to being able to identify and recognize them, which the Cycle of Anxiety exercise above helps with. The questions can be very helpful if a client or you yourself realizes that you might be catastrophizing, overgeneralizing, or magnifying/minimizing the importance of certain situations.
Cognitive Distortion Self-Therapy Questions
Building on our mention of cognitive distortions, catastrophizing can be a particularly crippling vicious mental process to those suffering from anxiety or depression.
These questions are especially useful because they can be easily adapted to meet a whole range of different levels and stages of emotion. They are aimed at helping you or your client understand that the worst possible solution is not always right.
When you feel you are at risk of catastrophizing, when you feel the onset of either anxiety or an unnaturally low mood, ask yourself:
- What are you worried about?
- How likely is it that your worry will come true? Give examples of past experiences, or other evidence, to support your answer.
- If your worry does come true, what’s the worst that could happen?
- If your worry does come true, what’s most likely to happen?
- If your worry comes true, what are the chances you’ll be okay…
- In one week? ____%
- In one month? ____%
- In one year? ____%
Self-Therapy Journey Questions: Discovering your Inner Critic
Based on work on the Inner Critic, these questions are designed to be self-administered. The test itself shouldn’t take longer than eight minutes, and the results will be most helpful to you if you answer them using your first reaction.
Based on the answers you give, you will ideally be able to get some understanding of the internal parts of yourself that give you unnecessary negative messages.
Each question is answered on a five-point Likert Scale ranging from Never to Always. Here are 6 questions as examples.
1. I set extremely high standards for myself.
Never / Seldom / Sometimes / Frequently / Always
2. I push myself to work very hard so I can achieve my goals.
Never / Seldom / Sometimes / Frequently / Always
3. When I think of trying something new and challenging, I give up before I begin.
Never / Seldom / Sometimes / Frequently / Always
4. I have a hard time feeling OK about myself when I’m not acting in accordance with my childhood programming.
Never / Seldom / Sometimes / Frequently / Always
5. It is hard for me to start on new projects because it is unacceptable to make mistakes even when I am just learning.
Never / Seldom / Sometimes / Frequently / Always
6. I am troubled by something I have done that I cannot forgive myself for.
Never / Seldom / Sometimes / Frequently / Always
The Self-Therapy Journey Inner Critic questions can be found on selftherapyjourney.com.
Using Self-Therapy for Anxiety
Unpredictability is part of the very nature of anxiety. Triggers can be internal or external, and it’s easy to feel overwhelmed fairly quickly.
As mentioned, not everyone can access a therapist instantly, so guided self-therapy can be incredibly helpful for dealing with daily occurrences that might lead to moderate or mild anxiety (Cuijpers et al., 2010).
How does self-therapy work for anxiety?
Often, self-therapy is used as part of a stepped-care model. This means it is considered a low-intensity treatment which individuals with anxiety can do without therapeutic intervention. At the same time, carrying out self-therapy for anxiety can help us understand if a more high-intensity approach is required, while also being a useful tool to use alongside one-on-one therapy (Gillihan, 2016).
There are different forms of self-therapy for anxiety and work-related stress including, but not limited to (Cuijpers & Schuurmans, 2007):
Psychoeducation
Resources to help you understand the nature of anxiety and the vicious Cycle of Anxiety are frequently found with self-therapy worksheets, questions, and exercises. We’ve given some examples above, and these sheets also provide valuable information about what treatments you or your client may be interested in pursuing;
Relaxation
Of course, relaxation is a huge part of treating anxiety. Meditations, guided breathing, music, exercise, and more can be part of self-therapy, and you can find more activities for targeting anxiety with these grounding tools.
Cognitive Restructuring
The ‘Challenging Automatic Thoughts’ exercise is a brilliant example of how cognitive distortions can contribute to anxiety and stress, as well as depression. Cognitive restructuring involves identifying and changing the maladaptive thought processes underpinning negative emotions and symptoms.
Anxiety Management Techniques
Typically used alongside cognitive restructuring and relaxation, these can include ‘grab-and-go’ self-therapy techniques that work well in everyday life. These can include positive self-talk, grounding techniques, and related exercises, some of which we’ve included below in our worksheets section.
Self Help Therapy for Depression
In a nutshell, self help therapy for depression uses a lot of the same techniques and approaches. Most self-therapy approaches to handling depression use CBT techniques to identify, combat, and change negative thoughts.
Individuals can easily learn to develop Cognitive Behavioural Therapy skills, and when self-directed, these can help to somewhat reduce feelings of anxiety as well—the two are often found together, as mentioned (Hirai & Clum, 2006; King et al., 2017).
Neuroimaging research also provides evidence to suggest that CBT helps to reduce activity in our self-referential medial prefrontal cortex, which is typically ‘on’ when we’re having negative self-thoughts (Yoshimura et al., 2013). Follow the link for a whole range of different CBT-related exercises you can look into at your own pace.
3 Self-Therapy Worksheets (PDF)
Below is a selection of self-therapy worksheets that can be used as instruments for self help therapy.
Positive Self-Talk Worksheet
Instructions can be helpful if you are interested in practicing positive self-talk as part of self-therapy for anxiety or depression.
This worksheet starts by guiding you to recount a recent experience, one where you felt that your internal dialogue was unhelpful or even sabotaging. Common negative self-talk related to anxiety and depression includes thoughts such as “I’ll never be able to handle this”, “He/she must hate me”, or “Things didn’t go right because I’m useless/not good enough/etc”.
Once you’ve recalled this experience, ask yourself:
- What was the situation?
- How did you feel?
- What did you do?
Next, we move to challenge your Self-Talk using ‘5 Cs’. Here’s a slightly shortened excerpt from the worksheet:
Catch it – recognize that you’re engaging in unproductive, damaging self-talk.
Control it – Stop! When you find yourself thinking negatively, break the vicious negative cycle by saying STOP to yourself.
Challenge it – Challenge what you’re saying to yourself. Ask yourself ‘Is it helpful? What evidence do I have that what I’m thinking is really true? What is the evidence against it?’
Change it – Turn your negative self-talk into positive ones that are grounded in reality. This is important to help evoke more pleasant and helpful emotions.
Cherish it – Enjoy the positive emotions and the feeling you have just created!
This worksheet can be found in its full form from the Winona State University, including more detail on powerful challenging questions to pose to those negative messages.
Gratitude Exercises
Not all self-therapy exercises are rooted in CBT, exposure therapy, or similar. It’s well known in positive psychology circles that practicing gratitude is associated with lower levels of stress and depression (Wood et al., 2008).
You can easily use these worksheets yourself, or help your clients learn how to practice gratitude by getting involved in several activities:
Journaling
By taking time each day to record a few nice things that happened, you can reflect on these if and when you feel anxious or depressed. Big things can come in small packages, so ‘good things’ can be anything from seeing trees in flower or helping someone across the road. Use this gratitude journal as an easy way to get into the habit.
Appreciation
Visit those you appreciate, or those who have had a big positive impact on your life. Say ‘thank you’ and looking for reasons to thank people. This expressing gratitude exercise will guide you.
3 Recommended Books and Workbooks
- Illustrated Workbook for Self-Therapy for Your Inner Critic: Transforming Self-Criticism into Self-Confidence (Amazon) by Bonnie Weiss – an illustrated, comprehensive and easy-to-use set of IFS-based exercises for self-therapy. Simple and straightforward yet powerfully presented, it’s suitable for teens as well as adults.
- Self-Therapy For Your Inner Critic – (Amazon) by Earley and Weiss, both. More in-depth information on the Inner Critic, the different types, and how we can harness our Inner Champion to counteract attacks from the former.
- Self-Therapy: A Step-By-Step Guide to Creating Wholeness and Healing Your Inner Child Using IFS, A New, Cutting-Edge Psychotherapy (Amazon) by Jay Earley. Complex-seeming IFS concepts made simple and clear, as well as help sheets that you can use in your own inner child healing.
6 Quotes on Self-Therapy
If you’ve decided that self-therapy is something you’d like to make use of, you may appreciate knowing that many others have also been there, and benefited greatly from it, too. Some quotes for your inspiration:
“There is nothing noble in being superior to your fellow man; true nobility is being superior to your former self.”
Ernest Hemingway
“Of all the judgments we pass in life, none is more important than the judgment we pass on ourselves.”
Nathaniel Branden
“Learning to love yourself is like learning to walk – essential, life-changing, and the only way to stand tall.”
Vironika Tugaleva
“If we don’t change, we don’t grow. If we don’t grow, we are not really living. Growth demands a temporary surrender of security.”
Gail Sheehy
“If you don’t like something change it; if you can’t change it, change the way you think about it.”
Mary Engelbreit
“The greatest discovery of my generation is that a human being can alter his life by altering his attitudes.”
William James
A Take-Home Message
Today, we’ve covered a few of the key schools of thought when it comes to Self-Therapy. We have also looked at some simple ways to start, and its potential applications for dealing with anxiety and depression. Hopefully, some of the resources in this article have been interesting… what do you think?
How do you feel about self-therapy? Have you found any of the approaches we’ve covered to be helpful?
We hope you enjoyed reading this article. Don’t forget to download our 3 Positive Psychology Exercises for free.
References
- Anxiety Canada. (2018). Self Help – Cognitive-Behavioural Therapy (CBT). Retrieved from https://www.anxietycanada.com/help-resources/cbt/self-help-cognitive-behavioural-therapy.
- Cuijpers, P., & Schuurmans, J. (2007). Self-help interventions for anxiety disorders: an overview. Current Psychiatry Reports, 9(4), 284-290.
- Cuijpers, P., Donker, T., van Straten, A., Li, J., & Andersson, G. (2010). Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies. Psychological medicine, 40(12), pp.1943-1957.
- Gillihan, S. J. (2016). Therapy without a therapist? Psychologytoday.com. Retrieved from https://www.psychologytoday.com/us/blog/think-act-be/201609/therapy-without-therapist
- Hirai, M. & Clum, G.A. (2006). A meta-analytic study of self-help interventions for anxiety problems. Behavior Therapy, 37(2), pp.99-111.
- King, R. J., Orr, J. A., Poulsen, B., Giacomantonio, S. G., & Haden, C. (2017). Understanding the therapist contribution to psychotherapy outcome: A meta-analytic approach. Administration and Policy in Mental Health and Mental Health Services Research, 44(5), pp.664-680.
- Makuch, G. (2014). Self Counseling: Be Your Own Therapist. Retrieved from http://www.theclearingnw.com/blog/self-counseling-be-your-own-therapist
- Martin, A. (2014). The Importance of Self-Counselling. Retrieved from http://www.thecounsellorsguide.co.uk/importance-selfcounselling.html
- NHS Inform. (2018). Self-help therapies. Retrieved from https://www.nhsinform.scot/healthy-living/mental-wellbeing/therapy-and-counselling/self-help-therapies
- WebMD. (2018). The Difference Between Counselling and Therapy. Retrieved from https://www.webmd.com/mental-health/guide-to-psychiatry-and-counseling
- Weiss, B. (2018). Self-Therapy Workbook Exercises. Retrieved from https://s3.amazonaws.com/Self-Therapy-Workbook/Self-Therapy-Workbook-Exercises.pdf
- Winona University. (2018). Self-Talk: Identifying, Challenging, and Changing. Retrieved from https://www.winona.edu/resilience/Media/Self-Talk-Worksheet.pdf
- Wood, A. M., Maltby, J., Gillett, R., Linley, P. A., & Joseph, S. (2008). The role of gratitude in the development of social support, stress, and depression: Two longitudinal studies. Journal of Research in Personality, 42(4), pp.854-871.
- Yoshimura, S., Okamoto, Y., Onoda, K., Matsunaga, M., Okada, G., Kunisato, Y., Atsuo, Y., Kazutaka, U., Suzuki, S., & Yamawaki, S. (2013). Cognitive behavioral therapy for depression changes medial prefrontal and ventral anterior cingulate cortex activity associated with self-referential processing. Social cognitive and affective neuroscience, 9(4), pp.487-493.
