How can you help approval-seeking clients stop fearing disapproval?

by Pavel Somov, Ph.D.

Psychological inoculation is exposure-based stress tolerance training with the goal of helping the client become less vulnerable to disapproval, criticism, rejection, and invalidation. You can teach your client to inoculate themselves against others’ disapproval in this way:

1. Help your client identify a particular thought of disapproval that he/she fears. For example, your client may say, “I don’t want people to think that I am socially anxious.”
2. Invite your client to participate in a “disapproval simulation.” Explain that you, the therapist, will be thinking the identified thought for one minute while client tolerates this simulated disapproval.
3. Sit in silence, looking at the client, thinking the thought in question.
4. Help your client recognize that the mere fact of this disapproval did not result in any fundamental changes in him or her.
5. Help the client identify coping options to further lessen distress (e.g., breath focus and self-affirming self-talk) and repeat simulations until client evidences habituation, with no anxiety or changes in self-view.
6. Leverage generalization from these in-session precedents by role-playing specific persons whose disapproval client dreads (e.g., “Now imagine that I am your boss having this thought about you,” follow with disapproval simulation).

Learn more about Pavel Somov and his books.