Can a 4-Step Self-Help Therapy Technique End Upset Feelings?

Therapists use this powerful treatment strategy. Can it work also for self-help?

Posted Nov 21, 2017

(c) stokkete/fotosearch
Source: (c) stokkete/fotosearch

That was then, this is now. That’s what I call this powerful visualization technique. The visualization, which consists of just four questions, guides super-rapid psychoanalytic-like exploration. It generally concludes with near-instant relief from upset feelings. I use the technique often in my therapy practice. I describe it in my latest book, Prescriptions Without Pills, which is for therapists and also for self-helpers. But can readers really use the visualization on their own? Will it work as a self-help strategy when you feel upset—down, scared, annoyed, or beset with any negative feeling?

You can be the judge by trying it out yourself. This blog post gives you how-to information in the form of a four-question prescription. It then offers an example, sent to me by a friend who offered to try it out on herself and share the results with my readers. 

Here’s the how-to, adapted from the prescription on page 30 of Prescriptions Without Pills.


Prescription #2.5: That Was Then, This is Now

Sit in a comfortable chair and close your eyes. Ask, or have someone you trust read to you, the following series of questions.

Pause after each question to let the answers gradually arise to your conscious awareness.

Verbalizing the answers aloud to the person reading the questions to you, or writing them out, is generally preferable to just thinking about them.

To start, bring to mind the upsetting feeling or thought. Identify the situation that triggered it. Note where the feeling is located in your body, how it feels. Note too, on a scale from zero to 10, how intense the feeling is.

Now you're ready for the four questions.

1. How old do you feel when that feeling comes up? 

A second version of this question is to allow an image to appear on your visual screen of an earlier time in your life when you experienced a similar feeling. How old were you then?

2. What is the same then and now?

Give details.

3. What is different now that you are older?  

As you get in touch with an older part of you that can talk with the younger distressed part of you, allow that voice to console the younger part.

4. Given this deeper understanding of you then versus now, what might be alternative ways of responding to the present situation?

Notice what you feel as you generate these new options. Observe, with your eyes still closed, how you feel as you see yourself trying out one of these new responses. If the first option you see yourself trying out doesn't seem to work, think of additional ideas and notice how you feel with these plans of action. 

Keep at the problem-solving until you choose a plan of action that you feel ready to implement. Notice then how you feel. Probably it will be significantly calmer and more confident.

If someone has been reading the questions to you, discussing your observations and conclusions with that person may be helpful.


To test the visualization’s use in a self-help format, I asked a friend, Dr.  L., if she would be willing to try it out. 

Dr. L, admittedly, is a therapist herself. She is even the author of Get Lost Girlfriend!, an impressively helpful book about toxic relationships.   

Still, I was very pleased with the positive results Dr. L described when she wrote back to me sharing her experience. The exercise proved to be simple and straight-forward enough that it genuinely helped her to get beyond an emotional reaction that had been troubling her.

Here’s what Dr. L. wrote to me, with permission to share it. Thank you, Dr. Livingston, for your willingness to contribute to this project!

The letter from Dr. L. About Using the 4 Steps of Quickee Self-Help Therapy

To my friend and colleague, Dr. H.,

I just had an extraordinary revelation as a result of the self-help exercise you suggested that I try, the technique you call That Was Then, This is Now.

I used the technique to address a strongly upset feeling I’ve been experiencing lately. The feelings have to do with my adjustment to single life after a 28-year marriage, a marriage that I had believed was going to be forever.


Who knew!

Divorce was not at all anything that I expected might ever occur in my life. And yet, here I am after all this time, living in my own apartment . . . and alone on many nights.

Not all nights. I found a great friend who sometimes shares his evenings with me. On those evenings I feel peaceful. I feel pleased with my progress in healing from the trauma of an unexpected divorce. 

But on the nights I’m alone, ugh. I can’t sleep. I feel incredibly sad, a little frightened and overwhelmed by a bad, icky feeling. That feeling goes with the thought “There’s something wrong with me. Right? Must Be. Otherwise, I wouldn’t be alone.”

These emotions make being alone at night so uncomfortable.

So I was intrigued when you asked me, “Would you like to try exploring the feelings with my That Was Then, This is Now technique? I’d like to know how it works as a self-help treatment.”

I had no idea what the technique was, but I felt immediately willing. Anything to potentially get rid of those frightened and depressing feelings. I said, “Sure.”

You then offered me the instructions from your book Prescriptions Without Pills

Here’s what happened, following the instructions, I thought again about that scared and icky feeling. I felt it in my chest and in my stomach. The feeling was like a big poisonous knife twisting within me. I felt it very strongly, at about a level eight on a scale from zero to 10. 

Next, I opened my eyes to read each question and then closed them to think about the answers.

Question #1: How old do I feel when that icky and painful feeling comes up, and with it the thought ‘There’s something wrong with me!’?

The feeling brought me back to being under two. I was lying alone in my crib. I hated being alone in that room. There were neon lights from the stores outside flashing monstrous shadows and images that were scary. The one time I climbed out of my prison bars and began my way downstairs, my father boomed at me from two floors down in the store, “If someone doesn’t get back in their crib very soon, someone is going to be very sorry!” 

OMG!!! Shocked and terrified, I scurried back to the discomfort of my bed.

Doesn't sound so bad now, but at the time it was terrifying, creepy. How could he know I was out of my room?! He was all the way downstairs. How much noise could I have made in my feetsy pajamas? Truth was, my big brothers had informed on me.

That angry threatening voice had repeated in my mind for a long time. I was a bad little girl.

Question #2 What is the same then as in the situation that triggers these feelings now?

In both cases, I feel abandoned, alone, and like I’m not worthy of being allowed to be with the others. Not worthy of being with my older siblings then, and with anybody now.

Question #3: And what’s different now?

I’m not stuck in my crib. I’m a grownup. I can stand up and walk. I can turn on the light. I can get even out of my apartment if I want to. And no one will yell at me if I do.

Question #4: What might be new ways of handling the present situation?

I can choose to do things, write, listen to an audio, watch a YouTube, join an online group and converse, go down to the front desk and talk to the guy on duty, read a book . . .

Now I have choices. I didn’t when I was so little.

I took a deep breath and sighed with appreciation.

“Right!” I said to myself.

My Conclusion

This was such a useful exercise.

It was so simple and yet it brought me to the core of a situation that had stopped me; petrified me, really. The exercise brought me back into a moment of vulnerability and then showed me that, unlike back then, now I have alternative options. What a relief.

Thank you, my friend. I feel so much better. I feel inspired that now if I’m alone at night and the old awful feeling and thought come up, the grown-up part of me can soothe the little girl part. I can put a new ending to situations that bring up the old feeling. Phew.


And how about you?  What happens when you ask yourself the four That Was Then, This Is Now questions?

Next time you find yourself mired in a negative emotion like anger or anxiety, give this technique a try.  Hopefully, you too will find it surprisingly helpful.

Here's a video example to build your confidence in how to use it.  Enjoy!