Table of Contents

Volume 4, Issue 12                                                                                 December, 2018


Understanding cognitive-behavioral therapy

A baseball metaphor

From Michael Otto:10-Minute CBT Oxford University Press, New York, 2011, pp 25-27

This is a story about Little League baseball….It starts with Johnny, who is a player in the outfield. His job is to catch fly balls and return them to the infield players.  On the day of our story, Johnny is in the outfield and crack! - one of the players on the other team hits a fly ball.  The ball is coming to Johnny. Johnny raises his glove. The ball is coming to him, coming to him….and it goes over his head. Johnny issues the ball, and the other team scores a run.

Now there are a number of ways a coach can  respond to this situation. Coach A is the type who will come out on the field and shout: “I can’t believe you missed that ball! Anyone could have caught it! You screw up like that again and you’ll be sitting on the bench! That was lousy!” Coach A then storms off the field. 

At this point, Johnny is standing in the outfield, if he is at all similar to me, he is tense, tight, trying not to cry, and praying that another ball is not hit to him.  If a ball does come to him, Johnny will probably miss it. After all he is tense and tight and may see four balls coming at him because of the tears in his eyes. If we are Johnny’s parents, we may see more profound changes after the game. Johnny, who typically places his baseball glove on the mantel, now throws it under his bed. And before the next game starts, he may complain that his stomach hurts, that perhaps he should not go to the game. This is the scenario with Coach A.

Now let’s go back to the original event and play it differently.  Johnny has just missed the ball, and now Coach B comes out on the field. Coach B says:  “Well, you missed that one. Here is what I want you to remember: high balls look like they are farther away than they really are.  Also, it is much easier to run forward than to back up. Because of this, I want you to prepare for the ball by taking a few extra steps backwards. As the ball gets closer you can step into it if you need to. Also try to catch it at chest level, so you can adjust your hand if you misjudge the ball. Let’s see how you do next time.” Coach B leaves the field. 

How does Johnny feel? Well, he is not happy - after all, he missed the ball - but there are a number of important differences from the way he felt with Coach A.  He is not as tense or tight, and if a fly ball does come to him, he knows what to do differently to catch it.  And because he does not have tears in his eyes, he may actually see the ball and catch it. 

So if we are the type of parent who wanted Johnny to make the Major Leagues, we would pick Coach B, because he teaches Johnny how to be a more effective player….But if we didn’t care whether Johnny made the Major Leagues…we would again pick Coach B because we care whether Johnny enjoys the game…..

Now while we may all select Coach B for Johnny, we rarely choose the voice of Coach B for the way we talk to ourselves. Think about your last mistake. Did you say, “I can’t believe I did that! I am so stupid! What a jerk!” These are Coach A thoughts and they have many of the same effects on us as Coach A has on Johnny….During the next week, I would like you to listen to see how you are coaching yourself. If you hear Coach A, remember this story and see if you can replace Coach A with Coach B thoughts. 

PL Reflection

The psychiatric resident has to learn four tasks to become a good psychiatrist:

1.    Help someone mourn a loss.

2.    Leave people alone.

3.    Hang up the phone.

4.    Encourage people.  

Leston Havens MD

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