SHRINKS THINK

THE BASIC ID

This is part of a Shrinks Think  series called Normal or Not  and deals with how mental health professionals think about normal or not normal and the tools they use in trying to decide who fits in one or another category.    These posts are useful reviews for therapists and good information for anyone working with therapists, but I  am also  sharing this information with the public.   Knowledge is power.  I think the best users of such services are educated consumers.  If you have not read the other Normal or Not Normal posts  click here  and start at the beginning. .Today, I  am posting about the BASIC ID.  It is one of the tools I found most helpful in trying to decide how to help someone.    This tool was developed by a behaviorist Arnold Lazarus.  Here is a quick and easy introduction to the BASIC ID.  Think of a troublesome event and then go through the following:

  • B=Behavior:  Describe what happened as if a video camera.  Start a bit before the event, the event, and then continue a bit past it.
  • A=Affect: What feelings are involved, again the feelings before, during and after.
  • S= Sensations: How did you body feel before, during, and after.
  • I=Images: This could be actual pictures or take the form of a story about the event.
  • C=Cognitions: What were you thinking or telling yourself about what was happening.  This usually takes the form of evalutative self-talk. “I can’t stand this.”
  • I=Interpersonal Relationships:  Who is involved but actually, but it is also helpful to look at how others in your life not actually involved might judge you or what is happening.
  • D=Drugs:  Think about more than drugs, alcohol or medications; think about the  body and biological state in general.  Does hunger, tiredness, illness, or horniness play a part in the problem.  All these impact.

Here is how I used this in my work with a young boy.  I call him Billy but that is not his real name.

 Billy’s BASIC ID   Billy is a twelve year old who was referred for bullying.  He had bloodied a number of smaller kids noses

ASSESSMENT

Behavior  Bullying occurs on the play ground, in Gym class, in bathrooms and in halls.

Affect  Billy shows remorse after bullying incidents, says others tease him, he feels hurt and then angry.

Sensations When asked about sensations, Billy shrugs his shoulders and denies any particular sensations.  One teacher who saw an incident reported Billy’s face reddened and he appeared close to tears.

Images  Billy says only that he sees red…this is not an unusual response to anger.  Has to do with blood vessels in the eye or so some think.

Cognition  Billy says “It’s not fair.  They shouldn’t tease me.”

Interpersonal relationships  Bullying involves a small group of other six graders.  Billy gets along well with almost everyone but this group of youngsters.  Teachers like him, but are concerned.  Parents recently separated. Billy says he is relieved, hopes parents divorce, father is thought to be abusive.

Drugs--Not on any medication.  Not believed to use any drugs or to drink.  Had his growth spurt and looks like a fifteen year old.

INTERVENTION 

Behavior = Billy is to give the “look” when teased and then walk away.  Rehearse.

Affect =  Diminish shame, re-frame problem as being the other kids–they are small, he is tall, they might be jealous.

Sensations  = Teach centering skills.  Have him use blushing as a sign to begin centering and put behavior plan into action.

Images = Have Billy see himself as being above this little kid stuff.

Cognition = Teach feeling thermometer, time out.  Teach calming self talk, find a slogan.

Interpersonal relationships = Get school to make Billy a hall monitor.

Drugs  = Discuss body changes with him, discuss puberty’s effect on hormones and that may make it harder to control his temper.

What happened after implementing the above and gaining Billy’s trust, is he told me he sometimes got “boners” and if the other kids noticed they teased him.  This lead to some normalizing and reinforced the idea the others might be jealous that he was growing up and they weren’t.

WARNING: You cannot  diagnosis yourself or a family member.  Three mental health  experts can examine the same person and each come up with a different diagnosis.  Same is true in dealing with many physical illnesses.  Modern medicine knows a lot, but is still based on group statistics and falls short when applied to one person.  So use this knowledge only to help you better understand what the professionals are saying and doing.  Be an educated consumer, but don’t practice medicine without a license. 

You can, however, use the BASIC ID as a self-help and problem solving tool.  I do.

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Agree or disagree, comments are always welcomed.

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