I have often found myself trying to perform cognitive therapy with my clients in a more embodied way and coined the term 3D-CBT for these instances. There are numerous reasons why this might be of benefit, but generally speaking it is about bringing in as many systems as you can to install new beliefs. Changing beliefs using only the vehicle of the intellect, which is the aim of CBT, might be considered rather limiting. The following exercise, is a good example of 3D-CBT, and is aimed at improving self-esteem and assertiveness being adapted from a CBT exercise I came across in one of the books I was prescribed at university. It’s an exercise that might be useful for people feeling limited by their tendency of people pleasing to the extent of neglecting their own needs. It might even be useful as a quick fix for shifting out of a depressive episode.

How to Complete the Bill of Rights Exercise

Stage One

The first step of the exercise is to come up with list of needs, that you would like to declare for yourself by writing up a personal Bill of Rights. The list should include things that you believe you have been denying yourself, but maybe shouldn’t be. There are no right or wrong answers, and everyones list will be different, but this list might include things like;

I have the right to get support

I have the right to express sadness

I have the right to pamper myself

I have the right to make mistakes and to learn from them

I have the right to say no

I have the right to change my mind

I have the right to feel angry

I have the right to protest about things I do not like

I have the right to avoid certain people

Stage Two

The second part, an optional part that I have added to the exercise, is to say your list of rights or needs out loud. This is to be done in an expressive and explicit way, while simultaneously safely hitting something. At my practice, I have a set of materials on hand for this exercise, including a large foam cube, a tennis racquet and a soft combat-bat. But a cushion being struck against the seat of a sofa, or bed mattress works just as well, so long as it’s done safely. Another tip is, to have your knees bent to stay grounded, and to be raising the instrument you’re hitting with, exactly vertically with both hands above your head opening your chest and taking mindful breaths between declarations. This is a technique that comes from the earlier body psychotherapy tradition of the Reichian movement, which brought with it the practice of bioenergetic and expressive processes to incredible effect.

If hitting something is too daunting for you, simply standing, really feeling the ground and taking an assertive akimbo stance in front of therapist, an empty chair or an imaginary group of friends, family work colleagues etc, is another useful option.

Why Express a Bill of Rights Out Loud?

In completing the bill of rights exercise in a more embodied and expressive way, you are bringing tremendous energy and feeling back to the declaration of one’s needs. It is a powerful and effective way of feeling assertive and brings a greater awareness of how it feels to declare one’s need, and often times how difficult it can be to declare them. By expressing your personal bill of rights forcefully, you are reminding yourself just how important your own needs are. And this is why it might be able to help someone shift out of a depressive episode.

Crucial to treating depression is understanding the depressive reaction being in response to disappointment and loss in life. Psychodynamically speaking, we assume that the depressed client has an early history of emotional deprivation and potentially caregivers who put their needs above the needs of the child’s or simply weren’t able to show up when the child needed their care. In response to the dilemma of needing but not entirely receiving the love and care he desires, the child rallies his entire being to block and negate the need impulse. This serves a dual purpose. Firstly, it allows the child to view the caregivers with some optimism and faith— if they don’t feel their need they don’t see they are being deprived. Secondly, it simultaneously prevents the feelings from being experienced and thus blocked from awareness. This is thought to be one possible cause for the feelings of worthlessness combined with the fatigued, numb affect so often a characteristic of depression.

By loudly and aggressively claiming back your needs, voiced as rights, this process aims to revert the tendency of self-negation. In many ways, it is the suppressed cry from childhood, demanding to be loved and taken care of. It is for these historical reasons that it is not easy for some people to hit something and declare their needs in such a way. In this instance, without being forceful, the therapist can invite awareness to this difficulty and explored. You may ask yourself whether something is being held or being suppressed within the body and breathe into that area, or to explore verbally why it is so difficult to declare very justified needs. Here is a good opportunity to explore how your needs were responded to when you were younger, or if there are any disappointments throughout your life that they may still be holding onto.

Who Is This Exercise For?

It is important to note that this exercise might not be a suitable process for really melancholically depressed and fatigued clients. On the other hand, I have witnessed on numerous occasions that when an individual in a state of agitated depression is able to really express their needs aggressively, usually to the point where they are out of breath, they often spontaneously break out of the depressive episode.

And, well, any sensitive, self-sacrificing individual could benefit from writing a list of rights, putting on some aggressive music (I can recommend Rage Against the Machine’s ‘Killing in the Name‘) and safely hitting something while yelling out the needs they have been denying themselves, especially if feeling depressed, or fed up with people around them taking advantage of their kind self-sacrificing nature.