1. In keeping with the central theme of the Pleaser, help the client to move toward a more flexible, common-sense goal and become a Pleaser who pleases himself or herself as well as others. The client can still find a place in life by being the one to maintain warm and happy relationships, but the give and take is balanced.2. Educate about the give and take in balanced relationships and establishing healthy priorities. Was there a parent or other adult who was supportive and loving? This is a history to tap into to find support through difficulties.3. Develop a sense of Who I Am. This can be done with such exercises as journaling (Pennebaker, 2004), lifestyle exploration (Powers & Griffith, 1987; Shulman & Mosak, 1988), or any exercise that encourages positive self-reflection.4. Teach and practice assertiveness skills that help the client learn that there is a position between submission and aggression.5. Have the client develop his or her own list of needed changes. If it is your list, the client may only be pleasing you and not making any real changes.6. Help the client find or create environments where it is safe to practice expressing his or her opinion, making his or her own decisions, and expressing his or her anger or frustration assertively (Boldt, 2007, page 154).
1. Listen to the client's story with compassion about three times. Three is usually enough. Make certain the client knows that his or her experiences with dominant, aggressive, and abusive others are not acceptable. They should never have happened.2. Eventually, switch the focus from compassionate witness of the client's stories of injuries to what he or she is willing to do to move toward the solution and healing of the injuries. Movement toward "survivor" means healthy acceptance of difficulty and pain while learning self protection. The client needs to know that the clinician can initially be of help in getting him or her to safety. But the client also needs to know how to make the changes that will increase self-help.3. Be sure the client can identify the red flags that signal abuse in relationships.4. Educate the client about healthy relationships and help eliminate beliefs that keep him or her away from relationships that are based on love, mutual respect, and equality.5. When the client is ready, encourage the recognition that while difficulties and pain are inevitable parts of life, suffering is optional (see FrankI, 1970).6. Initiate the process of forgiveness. Forgiveness is for the client, not for the abusers. It does not mean to forget. The client should remember what happened in order to avoid such relationships in the future. Forgiveness means understanding and letting go of the past, so it eliminates the ongoing power of the abuser over the victim.
1. Because the client is averse to seeking help, ask what he or she would like from therapy and how you can help. The client may not know exactly what he or she wants from therapy, but he or she does know what kind of help is tolerable.2. As long as the client is safe, in keeping with the Martyr personality style, respect the suffering and do not try to take it away. Encourage movement toward ways the client might be a useful example in society through defending his or her beliefs.3. Help the client recognize his or her authentic goal and live out his or her highest values.4. Encourage the client to develop a sense of personal direction in life. Can he or she explore his or her personal journey and discern its path? Spiritual direction, life lines charts, or journaling exercises help.5. Work on problem solving, especially Whose Problem Is It, Anyway? This may allow the client to use generosity to others in an appropriate way, without giving too much of himself or herself.6. Help the client make himself or herself the "cause" and do the work, as difficult as it may be (emphasize "difficult") to make the self a worthwhile cause. The client's skill is in transcending the painful and inevitable problems of life and death, so the difficulties of change are no obstacle (Boldt, 2007, page 154-155).
1. Help the client make use of anger, anxiety, and depression as signals to change. This can help defeat feelings of powerlessness and fatigue which accompany them.2. Outline the changes the client thinks are necessary but be sure to ask the client what change(s) he or she is willing to make. This discourages dependence and continued suffering and shows faith in the client's abilities. It can be the beginning of empowering him or her to take action.3. Be patient. Given the isolation, submissiveness, and aversion to asking for help that is characteristic of these personality styles, the client has already shown great courage by seeking help. Allow him or her to proceed at his or her own pace.4. Explore creative interests from childhood and encourage the client to rekindle them. Childhood may hold more clear memories of contented interests and worthwhile passions lost in this abusive relationship.5. Encourage the inherent strengths of the personality that help develop or restore self-esteem, creativity, and capability (Boldt, 2007, page 153-54).