Workbook The Positive Coping Skills Relationship Building

Identify Social Activities to Increase

One way to increase social contact is to re-engage with social activities you used to enjoy but have stopped doing. This might include attending family events you’ve been avoiding or calling up friends and acquaintances you’ve lost touch with. Another way is to sign up for continuing education classes or volunteer organizations. Yet another way is to participate in disease management support groups, which may be provided through local health agencies. Nonprofit societies focused on chronic illnesses such as diabetes, arthritis, COPD or coronary heart disease often sponsor this kind of support group and they are available in many communities. Check with your family physician or other healthcare provider regarding availability of disease management groups in your community.

Think of one or two social activities that you might try to increase. Write them here.

Social Activities:

 

 

 

Set Realistic Social Goals

For each of the social activities you have chosen, set a manageable goal for the coming week. Keep in mind that health conditions or mood problems make it difficult to get moving. As a result, you may need to set your goals lower than you ordinarily would. For example, if you want to contact friends you’ve lost touch with, your first goal might be to talk to one friend on the telephone for five minutes.

Try setting a social activity goal that would be realistic to do this week. Decide how often and for how long you will do the activity, and when exactly you’ll do it. Make sure the goal is scheduled: write it into your calendar or diary and then check it off once you’ve done it. It can be helpful to think of things you used to enjoy doing, before you developed your health condition. You might also look again at the list of activities on page 35.

Social Activity Goals:

Activity	How Often?	When Exactly?

Carry Out Your Goals

It’s important to realize that you often won’t “feel like” doing your social activity goals. Dealing with symptoms or fatigue, especially if you’re feeling discouraged, can reduce your motivation. But if you wait until you feel like it, most likely nothing will happen. Do the activity because you set a goal for yourself and because it will help you get better. After you’ve done and checked off each goal, you’ll see what you’ve accomplished.

If you’ve been avoiding people because of low mood, you might not get much enjoyment from social contact, at first. But as you continue to work on increasing social involvement, you’ll find yourself learning to enjoy other people again. Be patient – it may take weeks or months before you start feeling like yourself socially again.

When you complete a social activity goal, be sure to congratulate yourself. Every small victory is important and worth recognizing, especially when you’re dealing with the stress of a health condition.

If you didn’t succeed at your social activity goal, what got in the way? What can you do to make the goal easier? Perhaps your goal was too ambitious and you should try a smaller one over the next week or two. Scale back to something you’re sure you can do, even if you feel no better this week than you did last week. Allow yourself to get started slowly, gradually building more social contact into your life.

Review Your Goals

After a few weeks of doing your social activity goals, review the situation. Are there any goals that were not getting done? What got in the way? Do you need to reduce or change the goal?

If your goals were accomplished, do you want to increase them slightly or keep them at the same level until it feels natural? It’s your choice. You might want to add another goal.

Continue to set your ongoing goals, and consider adding additional goals as your energy permits. If you complete a task (for example, if you have now finished gathering information about recreational activities in your community), then move on to a new goal. Keep using the procedure:

• Set your 1-2 goals.
• Write them in your schedule.
• Check off each goal as you do it.
• Praise yourself each time.

Improving Your Relationships

Why Is this Important?

Dealing with a health condition can place a strain on relationships. Pain and other physical symptoms can make it hard to be with others. You might withdraw into yourself. Dealing with a health condition can negatively affect the quality of your relationships. But having rewarding and positive relationships makes it easier to live with a health condition. So it makes sense to improve your relationships, to make them as positive and supportive as possible.

How Can I Improve My Relationships?

We’re going to show you an effective way to help improve your relationships. It uses a method developed by a researcher who has studied this area for the last couple of decades, Dr. John Gottman.* Dr. Gottman has discovered that relationships are built up from:

Connection bids

A connection bid happens when one person reaches out to another for contact. A bid could involve an expression of interest or affection, a request for information, a humorous comment or offer of assistance – all the ways people reach out to each other. For example, “Would you like to see a movie with me?” is a connection bid.

Responses to these connection bids

When someone reaches out to you, you can respond in three different ways:

1. Turning Toward: You respond to the bid in an accepting, warm, encouraging or interested manner. “Yes, I’d like to see a movie with you. Do you know any good ones playing now?” OR “I won’t have any free time in the next couple of weeks, but I’d like to see a movie with you sometime after that. Could I call you then?”

2. Turning Against: You respond to the bid in a rejecting, hostile, irritable or dismissive way. “You know perfectly well I can’t go out to a movie. I’m exhausted.” OR “How come you never want to see a movie when I suggest it?”

3. Turning Away: You respond to the bid in an uninterested, ignoring way – maybe you don’t even notice the bid. “I haven’t felt much like seeing movies lately.” OR “I should go check my blood sugar now.”

Dr. Gottman’s studies show that people who respond more often to connection bids with a Turning Toward style tend to have stronger relationships.

Here’s what Dr. Gottman wrote about Turning Toward responses:

“If you want to build a deeper emotional connection with somebody, turn toward that person as often as you can…in general, if you can turn toward any significant person in your life – even when you’re angry, frustrated, complaining, or sad – your relationship will grow stronger. Then, if you face a time when turning toward one another is impossible, the goodwill you’ve accumulated will be enough to see you through to better times.” *

Now that you’re familiar with these basic ideas, you can use them to improve the quality of your relationships.

 

Recognize Connection Bids

A connection bid may involve:

• Asking for information
• Expressing caring or support
• Offering assistance
• Making a humorous comment
• Showing interest in a person’s opinion
  or preferences

There are other ways of seeking contact, but these are the ones we’ll focus upon.

So the first step is to identify bids for connection. We’ll start with your own connection bids. By learning more about your own bids, you will also get better at recognizing bids by others. It’s easier to identify your own bids – after all, you know what you’re trying to communicate.

As you go through your day, make a mental note each time you make one of the types of bids described in the list above. Then, when you get the chance, write a few notes about your bids. Of course, you’ll only be able to recall some of the bids you make, but it should give you a sense of your own way of connecting to other people. For each of the bids you notice, write down what you said or did and what kind of response the other person made – was it Turning Toward, Turning Against or Turning Away?

Here’s an example of writing down connection bids. Patricia is a woman of 63 who was diagnosed with coronary heart disease five years ago. This is what she wrote:

My Connection Bid	How the other person responded (check the one that applies)			Comment
	Turning Toward	Turning Against	Turning Away
Asked my nephew Tom about his recent holiday.
Complimented my next-door neighbour on her garden.
Asked my sister whether she had decided about selling her house.				She ignored my question. It must be a touchy subject.

 

Now it’s your turn:

My Connection Bid	How the other person responded (check the one that applies)			Comment
	Turning Toward	Turning Against	Turning Away

 

Notice How You Respond
to Connection Bids

Over the next week, notice when somebody makes a connection bid to you and how you respond: was your response Turning Toward, Turning Against or Turning Away? Make a mental note when you experience one of these bids, and later, when you get a chance, write down what happened. Use the form on next page.

Here’s an example of writing down responses to connection bids. This is what Patricia, from our example, wrote:

 

Now it’s your turn:

Other Person’s Connection Bid	How I responded (check the one that applies)			Comment
	Turning Toward	Turning Against	Turning Away

 

Make More Connection Bids

Since connection bids are so important for relationships, it makes sense to make these bids often. Perhaps you already make a lot of connection bids, but many people find that they don’t make as many bids as they would like. Furthermore, having a health condition may cause a person to be so preoccupied with pain and symptoms that they make few connection bids.

We’d like you to deliberately make two or three connection bids during the next week. You might ask someone a question about a hobby or their job, make a caring or supportive comment, offer some kind of assistance or make a gently humorous comment, etc. We’re not talking about connection bids that are profound or risky – just the kind of connection bids that happen in everyday conversation about small things. Then, when you get a chance, write down what you said or did, and how the other person responded.

Try to identify at least three of your bids and write down the results.

You can use the form below:

My Connection Bid	How the other person responded (check the one that applies)			Comment
	Turning Toward	Turning Against	Turning Away

 

Practicing this exercise will give you a better understanding of bids and the kind of responses they get. As you do the exercise, notice how it feels when somebody responds to your bid by Turning Toward, Turning Against or Turning Away.

Keep Practicing Connection Bids

If you want to achieve a lasting improvement in your connecting behaviour, set yourself the ongoing goal of making several connection bids each week and writing down what happens. Over time, you will become more skilled at making connection bids and this will help build your relationships, especially when you combine it with the next step.

Make More Turning Toward Responses

Since Turning Toward responses have a positive effect on relationships, it makes sense to respond this way often. Of course, there are situations where Turning Toward responses don’t make sense – we’ll leave that up to you to decide. Also, we can’t tell you how many Turning Toward responses to make in the next week – that depends on how many bids other people make to you.

When someone makes a connection bid during the next week, try to make a Turning Toward response. Remember, a Turning Toward response is one where you respond positively to that person’s bid, indicating that you are pleased by it and interested in further contact with that person. Even when you don’t agree with that person’s opinion or don’t want to do something they suggest, still try to respond in a way that shows interest in connecting.

It’s not always easy to express a Turning Toward response. Sometimes you’re feeling resentful of the other person or preoccupied by pain or too low to care much about contact. But it’s worth the effort to try this kind of responding to another person’s bid for connection. The stronger your connections are to other people, the more you’ll be able to get support with the burden of your health condition. It’s a long journey – sharing the journey with others makes it a lot easier.

© 2009 D. Bilsker, J. Samra, E. Goldner