Denise continued to fill out the Daily Record of Dysfunctional Thoughts and gathered evidence that she could relax her standards and be more tolerant of others’ viewpoints and foibles. She discovered that she felt happier, both with her- self and others, as a result.
The therapist set up several experiments with Denise to test a series of beliefs: that her friends would become punitive with her when she did not behave perfectly, and that her rela- tionships would become unpleasant and unde- sirable if she relaxed any of her rigid standards regarding how others should behave in rela- tionships. Through graded tasks, Denise coun- teracted her tendency to withdraw by gradually approaching new and sometimes unfamiliar situations. When she noticed herself imposing her standards of behavior on others, or noticed in herself the urge to become punitive, Denise practiced more open and accepting behaviors (by asking open-ended questions that reflected back her understanding of others’ responses, and by inhibiting harsh and judgmental state- ments). She practiced tolerating the discomfort associated with these new behaviors until they began to feel more comfortable and natural.
When Denise terminated therapy, her BDI score was in the normal range. The symptom reduction phase of treatment was successfully completed in 20 sessions.
The next section describes and illustrates a case example of schema-focused therapy for chronic depression.