ABSTRACT
This chapter looks at more core processes of change, the importance of being able to stand back and observe (perspective taking), approach behaviours (exposure) and the acquisition of new practical skills in several areas: emotional regulation, relationship management and mindfulness. Perspective taking involves the central act of finding new meanings. The four therapeutic approaches are concerned with, cognitive behaviour therapy, acceptance and commitment therapy, dialectical behaviour therapy and compassion focused therapy, each have procedures to develop what the authors can call an ‘observing self’. For example, Rengina might count in her head during an exposure therapy session. Cognitive and behavioural avoidance also prevent exposure. It is often considered essential to prevent such behaviours during exposure work. The practice of graded exposure has emerged, where increasingly challenging situations are used to produce exposure. The direct teaching of new skills and new understanding is very effectively done in group settings.
