Practical guidance for therapists tackling underlying, chronic beliefs about the self, the future, the world or other people held by clients.
Module 1: Understanding Passive Aggressive Behaviour Define passive aggression and differentiate it from assertiveness, aggression, and conflict avoidance. Explore common tactics (e.g. silent treatment, sarcasm, procrastination) and the impact on victims. Discuss origins of passive-aggressive patterns (e.g. upbringing, emotional suppression, indirect communication norms). Module 2: Recognising the Impact on the Client Identify emotional responses such as self-doubt, confusion, guilt, or chronic frustration. Examine cognitive distortions commonly activated (e.g. personalization, mind reading). Discuss how repeated passive-aggression can affect the client’s self-esteem, relationships, and coping strategies. Module 3: CBT Formulation for Passive Aggressive Victimisation Apply the 5-areas CBT model to situations involving passive-aggressive encounters. Map triggers, thoughts, feelings, behaviours, and consequences in these interactions. Use longitudinal formulation to explore deeper beliefs around conflict, boundaries, and worth. Module 4: Cognitive Interventions Help clients identify and challenge unhelpful thoughts such as “It’s my fault,” or “I mustn’t upset them.” Use Socratic questioning to explore alternative interpretations of ambiguous communication. Promote cognitive restructuring to rebuild a sense of control and reduce self-blame. Module 5: Behavioural Interventions Teach assertiveness and boundary-setting skills tailored to indirect hostility. Role-play effective behavioural responses to common passive-aggressive tactics. Reduce safety behaviours such as people-pleasing or emotional suppression. Module 6: Emotion Regulation and Self-Compassion Use mindfulness and emotional awareness techniques to manage internalised frustration or guilt. Support clients in developing a compassionate internal voice when feeling manipulated or dismissed. Reinforce skills for tolerating discomfort when asserting themselves. Module 7: Sustaining Change and Relapse Prevention Build a plan for handling recurring passive-aggressive dynamics in personal or professional life. Identify red flags and early warning signs of relational imbalance or manipulation. Reinforce long-term goals of clarity, assertiveness, and psychological resilience.
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