On the latest Got Therapy?, I asked Dr. Dan Rose a simple question: "Do you give yourself a self-affirmation?" His honest answer was that the whole idea can "feel a little cringey."
Here is the position: positive self-affirmation is a modest tool, and our field hands it out as if it were a treatment. The better clinical move is to help clients find where the critical voice came from and to answer their feelings rather than override them.
Start with the evidence we discussed on air. The article found that affirmations help some people, particularly before a challenge, or "if you already have a general sense of well-being, and there is stability in your life." The effect, as I put it, is moderate: "it's not a panacea." That is a respectable finding. It is not a mandate.
The risk runs the other way for the clients who most need help. Dan warned that an affirmation exercise can become one more assignment a struggling person believes they failed. Positivity can also cover pain that carries information, like a runner who keeps going on a sprained ankle. Dan's frame is the Buddhist second arrow: "Pain has its point, suffering doesn't." Suffering "is when we then shoot ourselves."
What should we do instead? Dan's first answer is to name the feeling and answer it. "We want to be able to think about how to answer an emotion like that." Avoiding it is "like putting it on one of those really expensive credit cards."
His second answer is genealogy. Self-talk is borrowed: "we often borrow voices from our past." Teachers who loved us, and "the math teacher that shamed us." The intervention is a question: "Whose voice is that?" Each reflexive put-down, Dan said, is "feeding that negative interject." Insight interrupts the feeding.
His third answer is capacity. Self-reflective function — "a loving curiosity about the experience you're having" — is something "that can be developed in therapy," and it is where "rewiring" begins. It is also what shame destroys. "The most toxic emotion for the capacity of self-reflection is shame."
None of this makes the cognitive tradition the enemy. Dan was generous to Beck, who built something teachable for clinicians and clients without the time or money for long analytic work. But he named the danger plainly: if we don't address the underlying concerns, "we may just be painting the barn."
If clients want an affirmation, Dan's version is the one worth teaching: "it's giving myself permission to be human." It isn't a boast. It's a perspective.
Affirmation, in his gym metaphor, "it's the 25-pound barbell. But there are other machines you need to use." Our job is to teach the whole gym.
Michael Baltimore co-hosts Got Therapy? with Dan Rose Psy.D. on Columbus Television.